AccountId: 011433970860
ContactId: c903a012-d44e-4a02-b190-6c76748190e0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 372220 ms
Total Talk Time (AGENT): 178454 ms
Total Talk Time (CUSTOMER): 98308 ms
Interruptions: 1
Overall Sentiment: AGENT=2, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/17/c903a012-d44e-4a02-b190-6c76748190e0_20250217T16:06_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], [PII] in [PII], how you doing?
[AGENT][POSITIVE] I'm good, [PII] how are you doing today?
[CUSTOMER][POSITIVE] Doing great doing great um I'm a broker and I'm just I'm just, just strictly trying to check on a wellness claim for one of our customers.
[AGENT][POSITIVE] Good. Well, how can I help you?
[AGENT][NEUTRAL] OK, so you're wanting to check claim status for members, is that correct, [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] I can help you with that. And what is your callback number?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Uh-huh. Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And the member's policy number, [PII]?
[CUSTOMER][NEUTRAL] 224-776-4
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] And [PII], as you know, any information I provide would be a verification of benefits and not a guarantee of payment.
[AGENT][NEUTRAL] First off, uh, if you would please verify your email address.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, thank you. And then also the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Normally I can see a claim in my system, but she went and did it herself so for some strange reason when the employee does it themselves, I can't see it on my side.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Hm, OK, so I can see that we have, we received two uploads fine on the [PII].
[AGENT][NEUTRAL] Of February, but they're still in line for reviews, so that's um let me just see if I can tell if that's.
[AGENT][NEUTRAL] Wellness, you said you did say it was for the screening benefit of the wellness, is that right?
[CUSTOMER][NEUTRAL] Yes, yes, ma'am, that I believe that's what she said.
[AGENT][NEUTRAL] Is she, was it for one or two different?
[AGENT][NEUTRAL] Dates of service, did she say? Because I just see what she uploaded.
[CUSTOMER][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] I just tell people to go, let's see.
[CUSTOMER][NEUTRAL] Can you please check on claims I filed 2525 I sent a snippet below.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Claims, OK.
[CUSTOMER][NEGATIVE] I tell people just to go through me because they constantly mess up what they're doing, which makes my job even harder, you know.
[CUSTOMER][NEUTRAL] And they, uh, so I don't, it doesn't say I I thought it was a wellness though.
[AGENT][NEUTRAL] OK, so just a moment.
[AGENT][NEUTRAL] It's just taking a moment, [PII], for everything to load. OK, so it does appear that these are wellness claims, they excuse me, they're still in the review process, but that ought to be very soon since she uploaded them on the [PII].
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Let's see, give me just a second.
[AGENT][NEUTRAL] Do you mind letting me place you on a brief hold for just a moment?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][POSITIVE] OK, great. Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You are on
[AGENT][POSITIVE] Hey [PII], thank you so much for holding for me. OK, so yes, both of them are still in line for review, but that ought to be.
[AGENT][NEUTRAL] Uh, very soon that that's completed. Now, she did, let me look at one thing on her profile, she did opt in for a text notification alert once it has been processed, so she should receive a text once it's been completed and then I can see she does have direct deposit information on file.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK OK perfect I'll I'll let her know.
[AGENT][NEUTRAL] So if, if the benefits are payable, then they should be, you know, but yes, uh let her know that it should be very soon on that being completed.
[CUSTOMER][NEUTRAL] OK, OK, I appreciate it. See, I wasn't sorry. I got a [PII] in the background screaming, uh.
[AGENT][NEUTRAL] I hear you. I hear the little people or little person.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] He, yeah, he's a little, he's a little under the weather, um, but the moral of the story is, I know the wellness, no, I I appreciate it. I know that a lot of times our wellness go faster than that, but I wondered if it's maybe how she filed it.
[AGENT][POSITIVE] Oh, I'm sorry.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] It does, and I, well, no, I mean, I can see that it was uploaded in the portal. I tried to reach the examiner who it looks like it's assigned to, but I think she's in a meeting. It kinda looks like she's in a meeting so um.
[AGENT][NEGATIVE] I'm gonna just message her, but again, provided that all the information is there, it should not be much longer.
[CUSTOMER][POSITIVE] OK, I will definitely let her know I appreciate it and um I appreciate your time today.
[AGENT][POSITIVE] Uh, well, you're welcome.
[AGENT][POSITIVE] Absolutely. Is there anything else I can help you with this morning?
[CUSTOMER][POSITIVE] No ma'am, I appreciate you sending that note over to her and I hope you have a good day.
[AGENT][POSITIVE] Sure. I hope you do too, [PII] and that's all I can help you with. Thank you so much for calling APL and I hope your little fellow feels better real soon.
[CUSTOMER][POSITIVE] Thanks so much.
[AGENT][POSITIVE] OK, you're welcome.
[CUSTOMER][POSITIVE] Take care bye bye.
[AGENT][NEUTRAL] You too. Bye bye.