AccountId: 011433970860
ContactId: c772bcf1-59a3-420a-8f53-a8a9c513b6da
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 941450 ms
Total Talk Time (AGENT): 193074 ms
Total Talk Time (CUSTOMER): 278692 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/c772bcf1-59a3-420a-8f53-a8a9c513b6da_20250609T13:31_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hi, good morning. My name is [PII], and I'm calling to verify.
[CUSTOMER][NEUTRAL] On a claim that
[CUSTOMER][NEUTRAL] Uh, the place where I had the procedure done said that um
[CUSTOMER][NEGATIVE] You guys haven't paid and they haven't received they're supposed to be issuing me credit and until they don't receive payment from you guys they cannot issue the credit.
[CUSTOMER][NEUTRAL] So I need you guys to check um for me what's going on.
[AGENT][NEUTRAL] OK, can I get a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what's your policy number?
[CUSTOMER][NEUTRAL] It is 0225.
[CUSTOMER][NEUTRAL] 8741 M as in Mary, L as in Larry number 8.
[AGENT][NEUTRAL] Alright, give me just one moment while I look that up and then I'll help you with claim status.
[CUSTOMER][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And can you verify your date of birth for me, please?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh that's.
[AGENT][NEUTRAL] And the address that we have on file?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And do you know what the date of service was?
[CUSTOMER][NEUTRAL] I believe it was on [PII]. I'm not 100% sure.
[AGENT][NEUTRAL] OK, it wasn't the [PII], so let me see.
[CUSTOMER][NEUTRAL] This, yeah, I don't know if you see it on the note. I'm sorry?
[AGENT][NEUTRAL] It wasn't for the [PII]. Let me see if I can find it for you.
[CUSTOMER][NEUTRAL] It's from the Baptist um facility.
[CUSTOMER][NEUTRAL] OK, but what they're gonna fuss it.
[AGENT][NEUTRAL] Would it have been for the [PII] possibly? You said it was the Baptist.
[CUSTOMER][NEUTRAL] It's not the hospital, it's a facility that does imaging.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK, you should have already had that on the file because on the notes you should have.
[CUSTOMER][NEUTRAL] First, when we called, you said that you had not received the claim.
[CUSTOMER][NEUTRAL] So they faxed it to you guys again.
[CUSTOMER][NEUTRAL] Did you guys receive it?
[AGENT][NEUTRAL] Well, that's what I'm looking up, but I
[CUSTOMER][NEUTRAL] Do you need the address of the of the facility?
[CUSTOMER][NEUTRAL] Who are you?
[AGENT][NEUTRAL] I need the date of service, but I'm, I'm looking real quick, OK?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] I am showing that a claim was was um received on the [PII]. Um, it's currently being processed so, so I'm not able to get in there and look at it. Give me one second, let me see if I can try something.
[CUSTOMER][NEUTRAL] OK, and what do you know what it is what it is for?
[AGENT][NEUTRAL] That's what I'm about to look up. Give me just one moment.
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] I see here.
[CUSTOMER][NEUTRAL] You know, the, the, the date of service was on the [PII].
[AGENT][NEUTRAL] The [PII], OK.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Of [PII] and that was the day that I did the.
[CUSTOMER][NEUTRAL] The, the procedure.
[CUSTOMER][NEUTRAL] It was on the [PII], but of course you probably did not receive the.
[CUSTOMER][NEUTRAL] Um, you should have received that already.
[AGENT][NEUTRAL] You said it was on the [PII].
[CUSTOMER][NEGATIVE] They're so difficult. These people are so difficult to return money to you, but they wanna charge you an
[AGENT][NEUTRAL] And you said it was the [PII], correct?
[CUSTOMER][NEUTRAL] Well, that's what I'm seeing here right now. It's a Baptist outpatient.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So I'm still not seeing a claim on file. Um, you do have the option if they're not going to file the claim for you, you can file the claim yourself and then it will, uh, payments would go to you instead of them. um, if.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEGATIVE] But, yeah, but the problem is that you guys should have to clean. They claim that that you guys have it.
[CUSTOMER][NEGATIVE] They're just waiting for payment and until that co-pay is not released, they're not gonna credit my credit card and I've been going like this for a while now. It's been two months now.
[CUSTOMER][NEUTRAL] And you should have received, didn't you, what did you receive, didn't you just say you just received the claim?
[AGENT][NEUTRAL] Uh, I, and I'm not able to see it.
[CUSTOMER][NEUTRAL] What is the claim for?
[AGENT][NEUTRAL] I'm not able to see it, so give me one moment.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] All right. Let me check the notes.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] Bye
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] Alright, give me just one moment. I'm trying to figure that out, um, but like I said, I'm not able to see anything for date of service of [PII].
[AGENT][NEUTRAL] Um, I am currently checking to see if that's the one that's currently being processed right now that was sent in on the [PII], so give me just one moment. I am still looking for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Because if it's yeah and just letting you know if it's being processed um I I'm not able to find them right away um because that's in the claims department but I'm gonna try and look it up for you OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][POSITIVE] OK thank you what's the look of your like.
[CUSTOMER][NEUTRAL] I'm gonna
[CUSTOMER][NEUTRAL] How much is
[CUSTOMER][NEUTRAL] It's a that's where I wanna go.
[AGENT][NEUTRAL] Alright, it looks like the claim that is currently being processed is for a procedure that was done on the [PII], so it's probably the one that you were talking about.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] So it is currently being processed. We received that claim on the [PII].
[CUSTOMER][NEGATIVE] Horrible.
[CUSTOMER][NEUTRAL] Yeah, I also have a question.
[CUSTOMER][NEUTRAL] You, you probably have, I, I, you know, you guys send me the um.
[CUSTOMER][NEUTRAL] You know, when you process claims and stuff, you send it to me by mail.
[CUSTOMER][NEUTRAL] So there's a claim there that is from a gastroentologist for a
[CUSTOMER][NEUTRAL] Miss uh Doctor [PII]. It's the last name [PII]?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEGATIVE] I don't think you guys were supposed to pay that claim because I never got the procedure done.
[CUSTOMER][NEUTRAL] I'm not sure if you have that claim. Are you able to see it?
[AGENT][NEUTRAL] And do you know when it was when the
[CUSTOMER][NEGATIVE] No, no, because I never got one.
[AGENT][NEUTRAL] Uh, when you did it?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] I know I had to schedule it, um, I, I was scheduling it, but
[CUSTOMER][NEUTRAL] Never got it done because I was under, I was doing I was doing other stuff. I, I was doing other stuff, so I, I had to cancel, but I don't want you guys to pay a claim if, if I haven't not done the, the, so I wanna check to see if what I wanna check is to see if you guys process it.
[CUSTOMER][NEUTRAL] Did you guys pay anything for that?
[AGENT][NEUTRAL] OK. Uh, give me just one moment while I put you on hold, OK?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Currently no agent staff. Goodbye.
[CUSTOMER][NEUTRAL] I'm gonna need you.
[AGENT][NEUTRAL] Alright, it looks like um it looks like someone who is in claim service or claim support is currently out, so is it all right if I have them call you back?
[CUSTOMER][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] Yeah, of course, of course.
[AGENT][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] Yeah, that's [PII], uh-huh.
[AGENT][NEUTRAL] Um, and they can call you back.
[AGENT][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] If they can um because I the claim that I really need to be processed is the one that I called you, you know, with the first one.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Because since they, when I went to do the procedure, they charged me $1500.
[CUSTOMER][NEGATIVE] So I need, I need for them to credit my credit card and they don't want to credit my credit card.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] How long more should I wait to call back?
[CUSTOMER][NEUTRAL] Do you know what claim number I should use to call back or?
[AGENT][NEUTRAL] Um, if a claim is being processed, it's not given a claim number until it's been processed, which is why it was a little bit trickier for me to look up. Um, I was able to finally find it and it was for that date of service that you had mentioned, um, but you won't get a claim number until then, uh, until it's been processed as far as waiting to get a call back from claims support for this other one, it should be about.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Hopefully no more than 24 to 48 hours. And uh if you would like, you can also ask them about this claim that's being processed um because that should give it enough time for it to have been processed as well.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, perfect. Thank you so much for your time. You have a nice day, OK?
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] Thank you for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Bye bye.