AccountId: 011433970860
ContactId: cb5ac023-684a-4584-9d72-2bb894b55306
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 824289 ms
Total Talk Time (AGENT): 345985 ms
Total Talk Time (CUSTOMER): 216870 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/18/cb5ac023-684a-4584-9d72-2bb894b55306_20250618T17:00_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, um, my mom was trying to reach somebody. She, she filed a claim and they sent a paperback saying the date was not legible.
[CUSTOMER][NEUTRAL] Um, and we, we're looking at the papers and I'm not sure what you couldn't read, but on the paper she sent in, the date is very legible.
[AGENT][NEUTRAL] OK, so you said that this is your mother's claim?
[CUSTOMER][POSITIVE] Yeah, and she's right here if you want to speak with her.
[AGENT][NEUTRAL] OK, so yes, ma'am, I will need to speak to her to verify some information. Thank you.
[CUSTOMER][NEUTRAL] OK, right.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] This is Ms. [PII].
[AGENT][NEUTRAL] Hi, Ms. [PII], what is your first name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. Is that correct?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] [PII], OK. Thank you. And Miss, what's a good callback number for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And do you um have your policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] Maybe I need another bring me the book. I got on another is the book down? Where's the book that we were looking to.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And
[CUSTOMER][POSITIVE] My great I to be on here.
[AGENT][NEUTRAL] Yes, Miss [PII], if we sent you something in the mail, your policy number probably would be on that correspondence that you received from us.
[CUSTOMER][NEUTRAL] But I'm not
[CUSTOMER][NEUTRAL] The on these papers that I sent you all that I filled down but I'm just not seeing it. What does it say policy number policy number, OK, it says ex extension number is that from ATL Baptist Health.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's let me look at this right the paper that they sent me today, the uh exclamation of benefits.
[AGENT][NEUTRAL] Yes, ma'am. It would be on your explanation of benefits, your policy numbers on that.
[CUSTOMER][NEUTRAL] OK, uh, 94 I mean 980089228.
[AGENT][NEUTRAL] Thank you. One moment, please. And you said that was 9 and then A as in apple?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] 0089228
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] So one moment please and let me get this pulled up.
[AGENT][NEUTRAL] OK, so first off, Miss [PII], it's my understanding that you received some documentation from APL where we were not able to read some of the information that was submitted for a claim, is that correct?
[CUSTOMER][NEUTRAL] Uh, the date of service for the test form is not legible. Please resubmit.
[CUSTOMER][NEUTRAL] With legible data service now I'm looking at the form.
[AGENT][NEUTRAL] OK, alright, so
[CUSTOMER][NEUTRAL] the form that I sent you.
[AGENT][NEUTRAL] Yes, ma'am. OK, so if you will um.
[CUSTOMER][NEUTRAL] And then
[AGENT][NEUTRAL] Yes ma'am, I can help you with this. I'll be happy to take a look at that. First, I will need to verify some information with you for security purposes, and I'll send this on any information that is provided would be a verification of benefits and not a guarantee of payment. So first off, if you will please verify your date of birth for me.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then, I'm sorry, the year is [PII]. Is that correct?
[AGENT][NEUTRAL] Is that what you said, Ms. [PII]?
[CUSTOMER][NEUTRAL] Yes
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Also your home mailing address.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. The phone number that is on file is the same as the one that you gave to me, so that is your best phone number that we should have, is that correct?
[AGENT][NEUTRAL] Hello, Miss. No.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEGATIVE] OK, I'm not able to hear you at times. Your voice is not audible on this end of the call.
[CUSTOMER][POSITIVE] OK, yes, she's saying yes, ma'am. She's saying yes to everything you asked her.
[AGENT][POSITIVE] OK, thank
[AGENT][NEUTRAL] And the last thing to verify is gonna be your email address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you very much.
[AGENT][NEUTRAL] Alright, on, on your explanation of benefits, Ms. [PII], what is the claim number?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] The claim number is uh 361-1989.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] I'm pulling up the image of your, of what we received, OK?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so Miss Miss [PII], on this document, yes ma'am, um, I don't know if did you all mail this in? How did you submit this to us?
[CUSTOMER][NEUTRAL] My daughter, uh, no, my daughter.
[CUSTOMER][NEUTRAL] What you, whatever you do with that phone to send it in.
[AGENT][NEUTRAL] Uh, is your portal profile set up?
[CUSTOMER][NEUTRAL] No, my daughter took a picture.
[AGENT][NEUTRAL] Did you all upload it?
[CUSTOMER][NEUTRAL] The what?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So there is a portal for APL M9 that I can actually email those user guides to you and if you want to have your.
[CUSTOMER][NEUTRAL] Yeah, ma'am. [PII] ma'am, she's [PII] some [PII] old. She can't do that and I'm not computer savvy either. That's why my sister, older sister did it for her.
[AGENT][NEUTRAL] OK, so the, what the image that we received is not legible. It's a, it's just a blur.
[CUSTOMER][NEUTRAL] What's the blur? The, the date. So the rest of it's not blur, the rest of it is clear, but you can't see the date.
[AGENT][NEUTRAL] The date? Yes.
[AGENT][NEUTRAL] No, a lot of the numbers are very blurry, but that one is just like almost, yeah, I mean, it's completely non-legible.
[CUSTOMER][NEUTRAL] Why hadn't I been contacted about this before, before you sent the explanation of benefits?
[AGENT][NEUTRAL] Yes, ma'am, because that's how the that the explanation of benefits is sent out for that purpose, Miss [PII].
[AGENT][NEUTRAL] When we receive a claim once it's been reviewed and processed, the explanation of benefits are mailed out.
[CUSTOMER][NEGATIVE] So how can she get that to you without going through all the different steps cause like I said, she's [PII] something [PII] old and she can't do it that way.
[AGENT][NEUTRAL] Yes, and the 3 options for submitting claims would be through the online service center portal, faxing or mailing, not emailing.
[CUSTOMER][NEUTRAL] be another month or better before I get my check.
[AGENT][NEUTRAL] So we cannot complete the review of the claim until we are able to receive the information where it can be read.
[CUSTOMER][NEUTRAL] the day on the phone.
[AGENT][NEUTRAL] Ma'am.
[CUSTOMER][NEUTRAL] The doctor send them those those dates. Why can't you take the date on the phone?
[AGENT][NEUTRAL] We can't take claims information over the phone legally.
[CUSTOMER][NEUTRAL] So the three options was the APL portal and what did you say? Email? No, you said fax.
[AGENT][NEUTRAL] Not, yes, ma'am, either the portal, fax or mail, not email.
[CUSTOMER][NEUTRAL] What's your fax number? I gotta get a pen.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Just let me know when you're ready.
[CUSTOMER][NEUTRAL] Get a pen and then I'm gonna try to see if I can fax it when I go to work tomorrow.
[AGENT][NEUTRAL] OK, sure.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And then also again, um, Miss [PII], what is your year of birth one more time?
[CUSTOMER][NEUTRAL] [PII], ma'am.
[AGENT][NEUTRAL] OK, so we will need to also receive an email or some documentation with her correct date of birth on there because the information is none for you on the application that was initially submitted when your husband took out this policy does not have your year of birth as [PII].
[CUSTOMER][NEUTRAL] Well, he, it's probably in [PII] because the DMV made a, a typo on my thing, but when I took, when I, when my husband passed and I gave the information, I gave the correct date of birth.
[AGENT][NEUTRAL] Mm, yes, ma'am, we still have the incorrect date of birth on the app. We've never received any, it doesn't show that there's anything been received to correct with to correct your date of birth.
[AGENT][NEUTRAL] Either a copy of your birth certificate or driver's license, if you have that, some form of legal identification showing your correct date of birth.
[CUSTOMER][NEGATIVE] And you just keep coming up with excuses.
[AGENT][NEUTRAL] No ma'am, this is not an excuse, this is just a legal.
[CUSTOMER][NEUTRAL] What is the fact
[AGENT][NEUTRAL] This is a legal process and your date of birth is not correct on file.
[CUSTOMER][NEUTRAL] Give my dog a
[CUSTOMER][NEUTRAL] Fax number please.
[AGENT][NEUTRAL] [PII]. Attention claims department.
[CUSTOMER][NEUTRAL] I need to I'm waiting.
[CUSTOMER][NEUTRAL] Ma'am, you know, you went too fast cause you're upset. OK, so can you read it slowly, please?
[AGENT][NEUTRAL] No, ma'am, uh
[CUSTOMER][NEUTRAL] I'm waiting 77.
[AGENT][NEGATIVE] No, ma'am. That is not correct.
[AGENT][NEUTRAL] 1
[CUSTOMER][NEUTRAL] OK, I'm waiting on
[AGENT][POSITIVE] Yes, ma'am. I'm trying to, and I'm not upset. I'm trying to provide you the information.
[AGENT][NEUTRAL] That you all are asking for.
[CUSTOMER][POSITIVE] I'm ready, ma'am.
[AGENT][NEUTRAL] The fax number is [PII].
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 94.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] Attention claims department.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And would you like to repeat it back to make sure you have it correctly?
[CUSTOMER][POSITIVE] I have it correctly, ma'am. You just went so fast the first time.
[AGENT][NEUTRAL] OK. And again, the getting her date of birth corrected, Ms. [PII] is very important because that can affect your processing of claims.
[CUSTOMER][POSITIVE] OK, thank you. Was there anything else you needed mom? All right, thank you and have a great day bye.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yes, ma'am, I hope you all do too if that's all I can help you with today. Thank you again for calling.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Hello?