AccountId: 011433970860
ContactId: cb5f80e7-0aa5-4ea9-95d4-b0567fed5a7d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 353140 ms
Total Talk Time (AGENT): 199169 ms
Total Talk Time (CUSTOMER): 145955 ms
Interruptions: 3
Overall Sentiment: AGENT=0.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/11/cb5f80e7-0aa5-4ea9-95d4-b0567fed5a7d_20250311T13:40_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Hi [PII]. This is [PII] calling. I had a question. I submitted uh a few um
[CUSTOMER][NEUTRAL] Claims
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, it's been a while and I was just calling to find out.
[CUSTOMER][NEUTRAL] The status.
[AGENT][POSITIVE] OK, I'll be glad to help you. Go ahead and give me your name and your policy number, please.
[CUSTOMER][NEUTRAL] OK. The name is [PII].
[CUSTOMER][NEUTRAL] And policy number and hospital benefits, is that what you want what you need?
[AGENT][NEUTRAL] Uh, either in or out. Either either certificate number would day, Ms. [PII].
[CUSTOMER][NEUTRAL] OK. It's 01699394 ML 7.
[AGENT][POSITIVE] Alrighty, [PII], thank you so much for that information. Now while I'm pulling this up, go ahead and give me a good return telephone call number, please, ma'am.
[CUSTOMER][NEUTRAL] And MO.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] All right, Ms. [PII], thank you so much for all that information. Now go ahead and verify your date of birth and your address for me, please, ma'am.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alrighty, thank you so much for all of that information. OK, now you did call, are you calling to check status of some claims that you had submitted or the providers had submitted?
[CUSTOMER][NEUTRAL] I submitted
[AGENT][NEUTRAL] Alrighty, let me get over. Do you know some dates of service?
[CUSTOMER][NEUTRAL] Uh, oh, there's so many of them, um.
[CUSTOMER][NEUTRAL] Well, I had my hand surgery on [PII].
[AGENT][NEUTRAL] All right, so let's see.
[CUSTOMER][NEUTRAL] That's one of the services.
[AGENT][NEUTRAL] Alright, because yeah, you have a couple of matter of fact, the policy number that you gave me, you've actually flipped to a different policy number.
[AGENT][NEUTRAL] But we, we transferred over once you receive your claim, but I'm gonna give you your correct policy number that's gonna be your up to-date policy number unless you're sending an old claim.
[CUSTOMER][NEUTRAL] Wait a minute. Hold on, let me see, let me see.
[AGENT][POSITIVE] Yeah, I'm gonna, I'm gonna give you that correct number.
[CUSTOMER][NEUTRAL] I think I got it because I did cop um I printed it offline. I think it was 02472975.
[CUSTOMER][NEUTRAL] Is
[AGENT][NEUTRAL] Well, yes ma'am, that is your that, that is correct, yes ma'am. OK, you do have it. OK, just wanted to make sure you had that. Alright, let me get over here to your file. Let's see what I can find out.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] Alright, I see, I see a [PII] claim.
[AGENT][NEUTRAL] Looks like from the facility.
[AGENT][NEUTRAL] Yeah, we have received that and we are asking what we need. Let me go over here. Let's see.
[CUSTOMER][POSITIVE] Yeah, tell me what you need so I can have it for you.
[AGENT][NEUTRAL] Yes, ma'am. What we're gonna need is a medical diagnosis from your provider's office.
[CUSTOMER][NEUTRAL] Medical
[AGENT][NEUTRAL] OK. Your medical diagnosis, yes, ma'am.
[AGENT][NEUTRAL] And what you could do, since this is a facility bill, Ms. [PII], is call that hospital and tell them you want a copy of your UB 92 bill.
[CUSTOMER][NEUTRAL] Diagnosis.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] So UB
[AGENT][NEUTRAL] Yes ma'am, UB 92. Tell them to mail you that and then you just forward that on into us on the OSC website because that's what we're needing. Yes ma'am, we have to have that medical documentation from that doctor and provider's office, OK?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] That is what we are needing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Because I, I sent something that they had sent me.
[CUSTOMER][NEUTRAL] I think um
[CUSTOMER][NEUTRAL] Yeah, that's, that's where I think for the um the, the therapy and all that I had gotten from um
[CUSTOMER][NEUTRAL] Orthopedic Associates.
[AGENT][NEGATIVE] OK, well, we haven't received anything else.
[AGENT][NEUTRAL] Mm mm, but pretty much, you submitted it, mm, we, we hadn't gotten anything else. That's crazy.
[CUSTOMER][NEUTRAL] I submitted.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] But pretty much what we're gonna need anything that you send into APL, we, we're gonna need the diagnosis on it, the procedure codes on it, and who the bill is from and your ELB from your primary insurance carrier. We need all of those things when you submit something.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK, so I'll try to do that today. I know I will find the one from um Blue Cross and Blue Shield online. I can send those, but um I, I.
[AGENT][NEUTRAL] Yes, because we're gonna need that, yes, ma'am. But we also need that documentation with that medical diagnosis on it from any provider that you send us.
[CUSTOMER][NEUTRAL] OK. You'll be my me too.
[AGENT][NEUTRAL] OK. Yes, ma'am.
[CUSTOMER][POSITIVE] Yes, ma'am. Thank you so much.
[AGENT][NEUTRAL] Well, yes, ma'am. Ms. [PII], is that all I can help answer for you today?
[CUSTOMER][NEUTRAL] Yes, I was just wondering because those bills are coming in and um I didn't.
[AGENT][NEUTRAL] Yes, ma'am. I understand that, but yes ma'am. I always call here if you have any questions, OK?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][POSITIVE] Yes ma'am. Thank you so very much, [PII].
[AGENT][POSITIVE] Yes, ma'am. Well, you have a great day then, [PII]. OK. Thanks for calling APL. Yes, ma'am. Thank you. Mhm. Bye-bye.
[CUSTOMER][POSITIVE] Likewise. Thank you. Bye-bye.