AccountId: 011433970860
ContactId: cc884f3f-469b-45c6-a253-84be1f507338
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 389239 ms
Total Talk Time (AGENT): 141748 ms
Total Talk Time (CUSTOMER): 209766 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=-0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/cc884f3f-469b-45c6-a253-84be1f507338_20250213T17:01_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. With whom am I speaking to? How may I help you?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Yes ma'am. My name is [PII]. I was wondering if you could help me with a claim.
[AGENT][NEUTRAL] OK, what is the callback number for you please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and what's your policy number?
[CUSTOMER][NEUTRAL] I still haven't pulled it on just one second.
[CUSTOMER][NEUTRAL] Shouldn't take me too long.
[CUSTOMER][NEGATIVE] Well, I'll say that and watch it run slow today.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEGATIVE] Well, it's not pulling up fast.
[AGENT][POSITIVE] OK, no problem. I have another way to look that up for you. Give me one moment to get to that screen.
[CUSTOMER][NEUTRAL] That's me.
[AGENT][NEUTRAL] What is your social?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you for that. And OK, is the policy in someone else's name?
[CUSTOMER][NEUTRAL] No, it's in my name. It's in [PII].
[AGENT][NEUTRAL] OK, that social been pulling anything up. Let's take a look.
[CUSTOMER][NEUTRAL] OK. [PII] sorry.
[AGENT][NEUTRAL] Hold on one second.
[AGENT][NEUTRAL] Hold on one second. I'm sorry.
[AGENT][NEUTRAL] All right. What's your physical mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I pulled it up by your name and what's your date of birth followed by your physical mailing? Oh, well you gave me your address. So your name and your email. I'm sorry, no, your date of birth and your email. Sorry about that.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] That's OK. [PII] email is [PII].
[AGENT][NEUTRAL] Thank you for verifying all that information, Ms. [PII]. Now, do you need your policy number?
[CUSTOMER][NEUTRAL] Um, uh, right now I think I've almost got it pulled up. Hang on, I won't be able to look at it with you while I'm talking, but it may be.
[AGENT][POSITIVE] OK, no problem.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] If I can get it to come up on here, usually just pops right up and internet seems to be running slow today.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Uh, one more time here.
[CUSTOMER][NEUTRAL] Well, for some weird reason.
[CUSTOMER][POSITIVE] OK, well I think I got it now. There we go. OK, I am.
[CUSTOMER][NEUTRAL] Almost in it now right now I'm in the site.
[AGENT][NEUTRAL] OK, I just wanted to make sure you had your policy number, that's all. Now what is your question today?
[CUSTOMER][NEUTRAL] I was just checking
[CUSTOMER][NEUTRAL] Uh, OK. I, I spoke with I spoke with a representative yesterday about it. There's a particular claim from [PII] that I sent an EOB on, but it did not have enough information for y'all on that EOB. So today, my daughter faxed over a new, uh,
[AGENT][NEUTRAL] Question do you have?
[CUSTOMER][NEUTRAL] We, we had to go through the billing department of the hospital to get what y'all needed for the claim instead of the EOB and uh I'm just making sure whether y'all received it.
[AGENT][NEUTRAL] OK, and when did you send that? Yes?
[CUSTOMER][NEUTRAL] Um, no, today she sent it just maybe an hour or so ago.
[AGENT][NEUTRAL] OK, so she just sent it, that's not showing in our system. faxes and documents are not instant, so you would want to give us 24 to 48 hours for that information to be uploaded into the system. You can check back tomorrow if you would like.
[CUSTOMER][NEUTRAL] OK, well, my question is, that was all they were lacking. And what the lady spoke with me about yesterday, she said I wouldn't have to start my 7 to 10 business days over as long as we got that in today. Uh, do you know if that's correct?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, that's not correct, and, and I know who, who you spoke to and she's on my team. We're not trained to do that. I can't say definitively that she told you that, but we know that's not the policy. Uh, 7 to 15 business days always starts over once you have to submit new documentation.
[CUSTOMER][NEUTRAL] Well what she was saying.
[CUSTOMER][NEGATIVE] Well, I am so, I am so frustrated, to be honest, with this, because her words to me yesterday were as long as you got it in, it won't start over again, because I have waited and waited and waited on this claim. And I would, first of all, never dreamed that an EOB wouldn't be enough for y'all and have what you need on it. Cause that's one of the things you state is that you need an EOB or uh a claim. So I did the EOB and then I go through all the trouble.
[CUSTOMER][NEGATIVE] Of getting the claim. I spoke with y'all yesterday. The lady yesterday quoted to me that if I was able to get that in within the next couple of days before my 10 to 15 business days already run out on the claim that they're doing, that I would have to start over. And why would she tell me that if that were not true?
[AGENT][NEUTRAL] Um, Miss, Miss, Miss [PII], I'm not sure, but I'm looking at her notes that she put in the system. She did not notate that and all of our phone calls are recorded. So if that's something that, you know, you're
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Well, maybe you need to listen uh then because he did talk to me about it.
[AGENT][NEUTRAL] Well, you can, you can, you can raise that for someone to, to, you can, you can send that to a supervisor for them to listen, but, you know, because all of our calls are recorded.
[CUSTOMER][NEGATIVE] I mean, I'm not, I'm not trying to be difficult. I'm just saying I hate the way sometimes when I call y'all, I get one thing from another and then the other one says, oh we're not allowed to do that, and they didn't say that when they did say that. And that, that's frustrating. So are you telling me that if that claim goes in say I start another 7 to 10 or 15 now y'all are saying business days.
[AGENT][NEUTRAL] That is the process for everybody that has a policy through APL.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] I guess all of your representatives don't know that.
[AGENT][NEUTRAL] So I'm telling you 7 to 7 to 15 business days excluding holidays and weekends.
[AGENT][NEUTRAL] Perhaps if you get it in, you know, it may be sooner, but we don't guarantee that the workflow is 7 to 15 business days to be processed, excluding holidays and weekends.
[CUSTOMER][NEUTRAL] OK, do you think if I call back this afternoon the fax may be there so I can verify it?
[AGENT][NEUTRAL] Yeah, you can call back. You can call back this afternoon and check and see. Yes, ma'am. And I would check closer to [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK, thank you. Have a good day.
[AGENT][NEUTRAL] Alright, anything else I can help you with?