AccountId: 011433970860
ContactId: c6179826-d6ca-4484-b1e3-302b71e5fc7c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 777809 ms
Total Talk Time (AGENT): 437641 ms
Total Talk Time (CUSTOMER): 261745 ms
Interruptions: 2
Overall Sentiment: AGENT=0.1, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/c6179826-d6ca-4484-b1e3-302b71e5fc7c_20250421T13:37_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, the phone's breaking up. I didn't hear your name can you say that one more time?
[AGENT][NEUTRAL] This is [PII].
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII] on the care team. How you doing?
[AGENT][POSITIVE] I'm good. How are you, [PII]?
[CUSTOMER][NEUTRAL] I'm OK. Um, I have a member on the other line who wants to speak to a claims rep. He
[CUSTOMER][NEUTRAL] So he has a claim here. He's under the impression that there's some claims docs somewhere else that he submitted in April. I don't see anything past [PII] in line or on base.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, the policy number is 97205.
[CUSTOMER][NEUTRAL] And it's part two.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Did he happen to did he submit it through the OSC?
[CUSTOMER][NEUTRAL] Yes, and he says that he sees it on there and I'm like, you see it on the online service center? And he said, yes, and I can click on it. And it comes up and I'm like, what? Cause I don't see anything.
[CUSTOMER][NEUTRAL] Past [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Yeah, and there's not anything up under his other policy.
[AGENT][NEGATIVE] At all
[AGENT][NEUTRAL] Um, OK, let's see, let's see, let's see.
[AGENT][NEUTRAL] See, and I don't even see anything for March.
[AGENT][NEUTRAL] [PII] as far as stuff received.
[AGENT][NEUTRAL] I see [PII].
[AGENT][NEUTRAL] It was processed on the [PII] yeah it was processed on the [PII], but we received it on the [PII].
[CUSTOMER][NEUTRAL] Really?
[CUSTOMER][NEUTRAL] Oh yeah, yeah, the EOB, I mean, the [PII] is the EOB.
[AGENT][NEUTRAL] Oh, got you, got you. OK. I was like, I don't even say anything I'm so I don't know. OK, um, did he happen to mention like what it was?
[CUSTOMER][NEUTRAL] But I don't see anything for April.
[CUSTOMER][NEUTRAL] OK, yes. So on the last claim that we processed, um, ending in 9837, so we asked for the explanation of benefits for like two of his codes. So that's what he was uploading.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] I don't see it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Anywhere.
[CUSTOMER][NEUTRAL] But isn't the, OK, because isn't the OSC like linked with OnBase, right?
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And lying. OK, I'm just making sure cause I say that on the phone, so I want, I want to make sure I was saying the right thing.
[AGENT][NEUTRAL] Yeah, it is.
[AGENT][NEUTRAL] Yes it is so as soon as they upload it, it doesn't have to go through indexing like our paper or faxes do um it kind of automatically goes where it's supposed to because that person is putting in their policy number and it's so within a few minutes typically you can see that new mail.
[CUSTOMER][NEUTRAL] Cause I'm like, it's linked.
[AGENT][NEUTRAL] Is available in online mhm and then you see on his claim that confirmation number that's out there?
[CUSTOMER][NEUTRAL] Has come in.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That should appear or he should have gotten a confirmation number for his upload and so it should like we should be able to match whatever his confirmation number is with a document received.
[CUSTOMER][NEUTRAL] To that line.
[AGENT][NEUTRAL] Yeah, so just a heads up that's probably what I'm gonna do I'm gonna be like, hey, do you have some type of confirmation number or something out there that I can get so that we can see if like.
[AGENT][NEUTRAL] There was because I don't know I mean if it's not right exactly I have something to reference because if it's not there and he uploaded it through the OSC like that's out of my wheelhouse I have no idea where to find it. I can't go out to indexing and be like, oh yeah, you know, like did he say what day he uploaded it by chance?
[CUSTOMER][NEUTRAL] We have something to reference.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] No, he said it was about, so when I asked him, he said it was about a week ago, and I said because the last thing I'm seeing is [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And he said, well, it's on the online service center and I can, I said on APL online service center, and he said, yes, and I can click it. And I said, OK.
[AGENT][NEUTRAL] Weird. OK, um, yeah, I'll just have to go through and essentially telling the same thing and be like, OK, what, what is that number out there besides beside that that you've uploaded because.
[AGENT][NEGATIVE] It's not here that doesn't mean that it's not in our system but it's, it almost seems like it's lost somewhere, you know.
[CUSTOMER][NEUTRAL] We.
[CUSTOMER][NEUTRAL] Or he's thinking he sent it to us and sent it somewhere else, cause he has Medicare too. And I asked him that and he was like, no, it's APL. I said, OK.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Okey dokey. Well, we, we shall see.
[CUSTOMER][NEUTRAL] All right, hold on one moment, OK?
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Hello, Mr. [PII].
[CUSTOMER][POSITIVE] Yes, ma'am. Thank you so much for holding. I have [PII] on the line, I'm sorry, [PII] on the line and she'll be able to assist you further, OK?
[CUSTOMER][NEUTRAL] OK, [PII]. OK.
[AGENT][NEUTRAL] Hey, Mr. [PII], this is [PII]. How are you?
[CUSTOMER][NEUTRAL] I'm getting off to a rough start this morning.
[AGENT][NEGATIVE] Oh no.
[AGENT][NEUTRAL] Yeah, so [PII] was letting me know that that you had uploaded something for us about a week ago and for whatever reason we're not we're not seeing it in our system but you're able to click on it and everything. Does that sound right?
[CUSTOMER][NEUTRAL] And I hope you can hear
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Interesting
[CUSTOMER][NEUTRAL] Uh, you, uh, we will wait, you all were waiting on to see what amount Medicare pays.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And that's, that's the last form I uploaded and I can view the file on your website.
[AGENT][NEUTRAL] OK, um, when you're looking at our website and um you know it's showing where you've uploaded information, does it give you like um kind of like a confirmation number like does it say like for example it'll have like 4 or 5 digits like 95031 like it's just like a number for that file or whatever does it have anything like that that you can see?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm, yes, uh, it has, uh, the confirmation number it has uh OSC 96516.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 96516. OK, that is helpful. So what I'm going to do is because [PII]'s [PII]'s right there for whatever reason I do not see it here but with that information I can reach out to our um to our OSC team and be like hey I have a confirmation number that's not showing up you know on our side to be able to process.
[AGENT][NEUTRAL] I, I need you to find it for me.
[AGENT][POSITIVE] And see what they can do for us um and if you're OK with that, um, I, I can get that put in just as soon as I get off the line with you and get them to assist and hopefully it doesn't take them very long. I really don't know truthfully because I've I've never run into this honestly, um, we, we don't typically have this kind of issue with the OSC.
[CUSTOMER][NEGATIVE] I run into it every time, every time I, every, every 6 months when I, when I have to go and uh.
[AGENT][NEUTRAL] Really?
[CUSTOMER][NEUTRAL] And, and, and get my loop on shots and stuff. I run into the same thing every time.
[AGENT][NEUTRAL] That is so unusual. I wonder why.
[CUSTOMER][NEUTRAL] Yes, yes, and, and, and, and we make our payments on month, monthly payments on time, per month.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I'm gonna mention that to them as well.
[CUSTOMER][NEGATIVE] It's frustrating.
[AGENT][POSITIVE] Yeah, I mean, it would be for anybody, so yeah, I completely get that.
[CUSTOMER][NEUTRAL] It's very
[AGENT][NEUTRAL] I'm gonna mention that to them as well that like every 6 months or so you have the same issue so maybe they, I don't know what it would be, but maybe they can sort that out.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] It's same, it's
[AGENT][NEUTRAL] I don't know that it would be your.
[AGENT][NEUTRAL] Your um account specifically but maybe they can look at that. I don't know um but I am gonna mention it OK so let me get that in let me see if someone can locate this for me and get it on your policy so that we can get this processed for you and um is the contact number on file, the [PII], is that a good number to call you back at?
[CUSTOMER][NEUTRAL] Yes ma'am and please call me back today and let me know, let me know something.
[AGENT][NEUTRAL] I sure will. I will.
[AGENT][POSITIVE] Yes, yes, I will call you back today for sure hopefully they can get me an answer today, but if not I will call you back and still just let you know OK, I've got it in they're working on it they're not sure what happened, you know, whatever it is that they've told me and you know, hopefully be able to give you like hey give us another 24 hours or something like that.
[AGENT][NEUTRAL] Um, or I will contact you and be like, OK, they found it. I don't know where, what happened to it, but they found it and it's on there and we're gonna get it processed one way or the other. I will contact you back today.
[CUSTOMER][NEUTRAL] OK. Um.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else that I can do for you while I have you on the line?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] No, uh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] If you, if you, if you can find out that information uh.
[CUSTOMER][NEUTRAL] Not the last lady, not [PII], and not the lady before [PII], but the lady before uh that person.
[CUSTOMER][NEUTRAL] I think it was Miss [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, she was the one that
[CUSTOMER][NEUTRAL] One of the ones that told me that uh there was waiting on the uh
[CUSTOMER][NEUTRAL] Medicare summary statement showing how much Medicare paid before they could process.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] This part of the claim, so you know, and I sent that in.
[AGENT][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] And I, I gave you the confirmation.
[AGENT][NEUTRAL] Yes, and you said that that was OSC 96516, correct?
[CUSTOMER][NEUTRAL] Yes, OSC 96516.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, yeah, that, um, that lines up with how our confirmation numbers come through so yeah let me reach out to our team and see if we can hunt this down and figure out what happened to it and like I said I'll mention that you, you consistently are having this problem with you can see it on your end but for whatever reason it's not coming through on ours and see if they can figure out what's going on with that as well so hopefully you don't have this problem anymore.
[CUSTOMER][NEGATIVE] Yeah, cause it's almost time for me to go do this again, and we ain't got this solved.
[AGENT][NEUTRAL] Right, uh, yeah.
[CUSTOMER][NEUTRAL] I, I have to do this every 6 months.
[AGENT][NEGATIVE] Yeah, that is so frustrating.
[CUSTOMER][NEUTRAL] I gotta go back and do that.
[CUSTOMER][NEUTRAL] It is.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] Now, what if, what if I didn't understand the technology, I would lose this.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] But hopefully you can help me.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, I'm I'm going to do what I can to get to the bottom of it not only with this particular um document that you've already sent in but also the fact that you're continuing to have this issue um we you should not be having this issue you know every single time you try to submit something so um because I see that we are getting stuff because I see so many different confirmation numbers but for you to just randomly have stuff that you've sent in not come through but it's on your end that doesn't make any sense.
[AGENT][NEUTRAL] So definitely gonna mention that to them and at some point today either after they've found a resolution or if they have not yet I will give you a call before end of business today and let you know kind of where we're at OK?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, talk to you very soon, Mr. [PII].
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] All right. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.