AccountId: 011433970860
ContactId: cba6af74-2307-42cf-8314-b66247e9f1ce
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 527619 ms
Total Talk Time (AGENT): 230139 ms
Total Talk Time (CUSTOMER): 270391 ms
Interruptions: 7
Overall Sentiment: AGENT=0.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/20/cba6af74-2307-42cf-8314-b66247e9f1ce_20250220T20:19_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], is this um
[CUSTOMER][NEUTRAL] What is this a claims?
[AGENT][NEUTRAL] Um, this is a care team, um, but I can help you with a claim.
[AGENT][NEUTRAL] Were you trying to speak to someone in particular with clients?
[CUSTOMER][NEUTRAL] Well, I've been
[CUSTOMER][NEUTRAL] Well, not necessarily. I, uh, used to be an agent with you guys and I've been helping a policyholder with her cancer claims. And so, uh, I've found a form that I can help her do all this stuff, whatever that is. And so I've had a question about her most recent claim that we see online. Is that something you can help me with?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, yeah, we could take a look at that claim um I'm sorry, what was your name?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and then [PII], can I get a good call back number from you in case we disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Thank you. And do you have that policy number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I do it's 728463.
[AGENT][POSITIVE] Thank you one moment.
[AGENT][NEUTRAL] OK and then uh what was the name of the member this was for?
[CUSTOMER][NEUTRAL] Uh her name is [PII]
[AGENT][NEUTRAL] Got it, thank you, and I'm sorry [PII], what was your relation to her?
[CUSTOMER][NEUTRAL] I was the writing agent when I wrote the policy on her years ago.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Need a birth date and all that. They used to ask me for that.
[AGENT][NEUTRAL] Please, yes.
[CUSTOMER][NEUTRAL] OK, it's [PII], let's see, [PII].
[AGENT][POSITIVE] Got it thank you. OK, give me just a moment let me see if I can get.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Her information here.
[AGENT][NEUTRAL] And do you have a a claim number or a date of service?
[AGENT][NEUTRAL] For this particular claim?
[CUSTOMER][NEUTRAL] Uh, I do. Let me see if I can log in here. Uh, I'm looking for.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Actually I think secured site. Let me see.
[CUSTOMER][NEUTRAL] If I can find it.
[CUSTOMER][NEUTRAL] Well, where'd you go?
[CUSTOMER][NEUTRAL] OK, this may be it.
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Well, normally I can get right in here. I wonder why I can't.
[CUSTOMER][NEUTRAL] Get in here today like secured.
[AGENT][NEGATIVE] Probably because we're on the phone, you know, like taking your car to the mechanic. Nothing wants to work.
[CUSTOMER][NEUTRAL] Yes, it won't, it won't, it won't misbehave, will it? Um.
[CUSTOMER][POSITIVE] Well, what I can't believe this. I've had this here all morning long. Now it's like it looks good.
[CUSTOMER][NEGATIVE] Um, uh, well, I tell you what I noticed I had been working with [PII] in claims because there was a date of service of [PII] with the hospital bill, and I think y'all, I received it twice, uh, I had sent it but it's too blurry to read and so um.
[AGENT][NEUTRAL] April.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] I on Monday.
[CUSTOMER][NEUTRAL] Uh, had a real clear copy that was texted to me from Miss [PII]. And so I go for those CPT codes or whatever they were. Well, in the meantime, um, I think there's a new claim that just went out or approved at like $3800 just the latest one, you show that?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Latest one, yeah, 38, yes.
[CUSTOMER][NEUTRAL] It showed up on her
[CUSTOMER][NEUTRAL] OK, my question is, and her question was, does that include the um claim from 126-24.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] I'm just trying to follow that, make sure that's actually done because we've been working on it for months.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Yeah, that's all the dates of service. This is quite a large uh claim, but all of the items are from that date of service.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Oh, OK, is it like 4 different.
[AGENT][NEUTRAL] From [PII].
[AGENT][NEUTRAL] Oh, there's quite a few 123456789, [PII] looks like there are about 13 items. The only one that we were unable to pay a benefit on, give me just a moment, let me get clarification for that.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Oh it was the transportation benefit.
[CUSTOMER][POSITIVE] Oh yeah yeah yes which we understand.
[AGENT][NEGATIVE] That was the only one we were unable we did make a payment on all the other items.
[CUSTOMER][NEUTRAL] Right, and that totals of 3800 or 30 yeah.
[AGENT][NEUTRAL] 3802, yes.
[CUSTOMER][NEUTRAL] But that's just from [PII]?
[AGENT][NEUTRAL] All of those dates of service are from [PII]. Yes, ma'am.
[CUSTOMER][POSITIVE] Wow, I'll tell her that finally we've gotten that taken care of. OK, great. Well, we have.
[AGENT][NEUTRAL] Yeah that looks like it was pretty recent, um, that just that was just yesterday that it processed.
[CUSTOMER][POSITIVE] OK, good.
[CUSTOMER][NEUTRAL] OK, yeah, I called in the actual codes on Monday to April, and then I, I had a chance to email her a copy of that. I couldn't do it to, to the back office, uh, since it was a text to me. OK, so we still have more. She's been back in the hospital this in January and had some more surgery. So, huh, OK. Well, thank you. That was.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, well, and then going forward I'm sure you're aware of this, but I, you know, wouldn't be doing my job if I didn't recommend, um, if she would like if it's easier of course she can set up direct deposit, um, because this one is sending out as a paper check.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Right. How does she do direct deposit?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So um she could do to do it through the website or if it's easier we can send a form, a direct deposit form she could fill out and she could either mail that back to us or email it back to us.
[CUSTOMER][NEUTRAL] Oh, well, go ahead and mail that to her.
[AGENT][NEUTRAL] OK, I'll get a form mailed to it. Let's see, whatever is easier, honestly, um, if she has a, uh, I mean it depends, but typically I'd say it's easier with a desktop or a laptop computer, um, but a lot of the browsers will let you fill out that information through the computer and then you could just email it right back to us.
[CUSTOMER][NEUTRAL] Or could you, or do you need to email it to her?
[CUSTOMER][NEUTRAL] Oh, I didn't know that. She has a Chromebook. That's something she can do with it. I don't know the difference.
[AGENT][NEUTRAL] Mhm. Oh, that might work. Well, yeah, our website works the best with Google Chrome, so that I, I think so and that's what we use, um.
[CUSTOMER][NEUTRAL] Well, if you would email it to her and then also mail her one and I'll let her know those are coming.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure, let's
[AGENT][NEUTRAL] Let me verify we've got um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah, [PII].
[CUSTOMER][NEUTRAL] OK, let me, I'm gonna look and see what I have written. I see.
[AGENT][NEUTRAL] Looks like that might be [PII].
[CUSTOMER][NEUTRAL] OK, hang on one second.
[CUSTOMER][NEUTRAL] Yeah, [PII], yeah, uh, let me see here.
[CUSTOMER][NEUTRAL] Hers is [PII]
[CUSTOMER][NEUTRAL] And then [PII].
[AGENT][NEUTRAL] OK, that was [PII] you said uh [PII]?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, his first last name [PII]. OK, so I can go ahead and send that form to that email and then of course the uh mailing address we've got is [PII].
[CUSTOMER][NEUTRAL] Yes, that's her.
[AGENT][NEUTRAL] Is that [PII]?
[CUSTOMER][NEUTRAL] I think it's [PII], yes, [PII].
[AGENT][NEUTRAL] I think it's how you say that.
[AGENT][POSITIVE] [PII], yeah. OK. OK, awesome.
[CUSTOMER][NEUTRAL] Yeah, what is, what is your name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK, and your direct number you at, uh, you're at um [PII], is that correct?
[AGENT][NEUTRAL] Um, no, well, that's our care team department, that's where I'm at.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] So care team is different from claims or what's the deal? What does the care team do?
[AGENT][NEUTRAL] Yes, yes, right, so care team is more uh the front lines so I can see a lot of things on the surface level, um, so for example if there was an issue or a deeper question regarding this claim, um, I would, you know, consult with the actual claim department.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, that's different. OK. All right. Well, thank you very much. I appreciate that.
[AGENT][NEUTRAL] Yeah, I think this department is fairly new, but it does take a load off of those, uh, claim specialists.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][POSITIVE] All good. OK. Thank you so much.
[AGENT][NEUTRAL] Yes ma'am, was there anything else I can help you with, [PII]?
[CUSTOMER][POSITIVE] Uh, no, that's it. Great. Thank you.
[AGENT][POSITIVE] Alright, yeah, thanks for giving us a call. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Uh-huh. Bye-bye.
[AGENT][NEUTRAL] Bye bye.