AccountId: 011433970860
ContactId: d5b83386-633b-4d11-b066-4ea7a05490ad
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 369190 ms
Total Talk Time (AGENT): 118106 ms
Total Talk Time (CUSTOMER): 214196 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/13/d5b83386-633b-4d11-b066-4ea7a05490ad_20250113T14:23_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning. I'm the policy holder and I have a claims question.
[AGENT][NEUTRAL] OK. How can I help you?
[CUSTOMER][NEUTRAL] Alright, um, you're probably gonna need my policy number to look me up though, um, so I can't find an EOB for a claim that um was sent to you guys in [PII], so I'm asking to pull that up and tell me was I paid how much and can I please receive an ELB by email.
[AGENT][NEUTRAL] OK. What time?
[AGENT][NEUTRAL] OK. What is your name, ma'am?
[CUSTOMER][NEUTRAL] Last name [PII]
[AGENT][NEUTRAL] Do you have your policy number, [PII]?
[CUSTOMER][NEUTRAL] Yeah it is it's right in front of me. Hold on here it is 71864.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Um, I would call you back if we were disconnected.
[AGENT][NEUTRAL] OK, we need to verify a callback number for you.
[CUSTOMER][NEUTRAL] But I wouldn't take your return call. I would call you.
[AGENT][NEUTRAL] OK, now that's the calls are recorded, so we'll just let that be recorded. Give me a second. Now the [PII], did you get that off of your ID card?
[CUSTOMER][NEUTRAL] No, I'm looking at it from the cover sheet that I sent with the claim. It says certificate slash policy number 718464.
[CUSTOMER][NEUTRAL] Now I've been with you all since uh let me think, [PII], so that number is embedded in my cover sheet.
[AGENT][NEUTRAL] OK, let's see. Alright, 718-464. What's your date of birth and your complete mailing address, [PII]?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] And your email address on file?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Showing a Gmail account on file.
[CUSTOMER][NEUTRAL] Yeah, I just gave it to you. I just read it out to you my email.
[AGENT][NEUTRAL] I'm showing a Gmail account.
[CUSTOMER][NEUTRAL] Um, it doesn't, I have, I have two, so it doesn't matter. It'd be [PII].
[AGENT][NEUTRAL] OK, thank you and did you say you'd like for us to check a claim status for you?
[CUSTOMER][NEUTRAL] Correct, uh date of.
[AGENT][NEUTRAL] And what is that date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so [PII], I'm just confirming that I have the right information, ma'am. [PII] through.
[CUSTOMER][NEUTRAL] There's only one claim in, in the year of [PII]. You'll only find one claim. [PII].
[AGENT][NEUTRAL] That's OK.
[AGENT][NEUTRAL] I still have to document it. Let me repeat it, please. [PII]?
[CUSTOMER][NEUTRAL] Discharge
[CUSTOMER][NEUTRAL] Yeah, I admitted [PII], discharged [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Give me one moment to locate the claim.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so I do not show that claim on file for May.
[CUSTOMER][NEGATIVE] Maybe that's why I haven't been paid.
[CUSTOMER][NEUTRAL] Are you certain you don't see anything there because it was emailed uh the whole claim was uploaded to your portal.
[AGENT][NEUTRAL] When was it uploaded?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I am not
[CUSTOMER][NEGATIVE] That's the only one I can't figure why I haven't been paid. So rather than saying you haven't paid me, my tact was to say, I can't find the EOB. So that would at least mean perhaps you have paid me and I've lost it. I can't lay hands on the EOB at all from the American public.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, I do not show a claim for that date of service that's why you've not received an ELB. There's nothing processed for that date.
[CUSTOMER][NEUTRAL] OK, well, that tells me I have work to do today to reupload it again, uh, or should I send a paper copy? It's like 38 pages.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Um, I mean, it's your choice. Yeah, you could upload it.
[CUSTOMER][POSITIVE] Well, I tried the portal. I did the portal on [PII] and y'all don't have it, and it, so I'll just courier it out instead because that way I have a number right, I'll send it again um thank you very much for helping me.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] What's the
[AGENT][NEUTRAL] What
[AGENT][NEUTRAL] What's the name of the hospital?
[CUSTOMER][NEUTRAL] Duke University Health System.
[AGENT][NEUTRAL] OK, I wanted to put that in your notes, so it's from Duke University. OK, did you have any other questions?
[CUSTOMER][NEUTRAL] You said it's from Duke. Um, Duke didn't send you anything.
[AGENT][NEUTRAL] I know it, but I just wanna put where the claim is, who, where you were, what hospital were you were in.
[CUSTOMER][NEUTRAL] Yeah, the hospital in question was 24 days at Duke University Medical DUH.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, I'm aware that you submitted it. I just wanted to indicate it's from, it's a claim where you had services at Duke University on [PII].
[CUSTOMER][POSITIVE] You're correct and indeed it, I also have the confirmation of the email on [PII]. I'll just pay file it with you all again.
[AGENT][NEUTRAL] So it's for my notes.
[AGENT][NEUTRAL] OK. All righty. Any other questions, [PII]?
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] That was it. I just wanted to know, hey, I can't find an ELB, so I'm sure I've lost, but here it's, here it's turned out you don't even have it. So here I go. I'll courier something over to you then. Thank you.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Yeah.