AccountId: 011433970860
ContactId: d822f1aa-4dbe-4486-a7a7-d3f1bebafc07
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 472019 ms
Total Talk Time (AGENT): 312435 ms
Total Talk Time (CUSTOMER): 105397 ms
Interruptions: 1
Overall Sentiment: AGENT=0.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/d822f1aa-4dbe-4486-a7a7-d3f1bebafc07_20250117T15:48_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. You're speaking with [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] over on the care team. How are you?
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Glad to hear it. I've got an insured on the line, uh, calling regarding uh cancer claim. Looks like we were, um, she had sent medical records. She just wants to see if that's been processed, if that's continued, excuse me, my goodness, if that's completed processing.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, what's the policy number?
[CUSTOMER][NEUTRAL] It is 02549206.
[AGENT][NEUTRAL] OK. This is for Miss [PII]. OK, let me see who this belongs to and see what they did for cancer. This is [PII]. She, uh, looked like she requested medical records. So, yeah, we have, we
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Mhm. She did say that she sent that information to us.
[AGENT][NEUTRAL] She, uh, we don't get medical records from the insured, we order them from the, from the provider, but, uh.
[CUSTOMER][NEGATIVE] Oh, that's what I thought. I was so confused.
[AGENT][NEUTRAL] Uh-huh. We don't, we, we don't, we don't, we don't ask her for the sent me, but you can let me speak to her and I can tell her that looked like something came in and, uh, look like the adjuster is getting medical records. And let me see who she ordered medical records from.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] Just to have it out here. Yeah, you can just let me, OK, you can let me speak to it. OK.
[CUSTOMER][POSITIVE] I appreciate that.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] Yes, ma'am. Thank you. Bye-bye.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Hello, Ms. [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] My name is [PII] and I'm in the claims department, and you're calling checking on your claim, is that correct?
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] OK. It looks like we received uh something came in our office on [PII]. It looked like on the [PII], the adjuster is pinning it cause she only request the medical records to rule out a pre-existing medical condition. So she's requesting medical records from your treating doctor and that's what she doing.
[CUSTOMER][NEUTRAL] Oh, OK. Uh, which doctor is she, uh, requesting that from?
[AGENT][NEUTRAL] Let me see, do that. I can see a note that she put anything to say who she requesting it from.
[CUSTOMER][NEUTRAL] Can
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh yeah.
[AGENT][NEUTRAL] Um, let's see, I don't see. Let me see, yeah, out here.
[AGENT][NEUTRAL] Uh, I, I can't tell who she requesting them from. I can try to, uh, let me see, see, I'm just looking at what was sent cause I don't see where she did it yet cause usually have something out there and the [PII] was Monday.
[AGENT][NEUTRAL] Uh, and I see where you're sending your information with the list of doctors. So she either a list got them from Doctor [PII] That's what you got on your paperwork, your uh doctor [PII]. So let me, let me see, can I, let me see, can I IM her and she can tell me for sure. Let me see.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] OK. Give me one second to see what she answered me back.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Does it say what preexisting?
[AGENT][NEUTRAL] We, we go back and ask for medical records from [PII]. That's what she's gonna ask for medical records for. So if you treated for this uh medical condition, that's what we'd be looking for to make sure that this, you didn't treat for this before you took out our policy.
[AGENT][NEUTRAL] On [PII]. Let me see, 249206. What doctor, did you request medical?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Records from uh insured.
[AGENT][NEUTRAL] OK, maybe she'll answer me right back. If not, I'll find out and I'll just give you a call back.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, cause that, yeah.
[CUSTOMER][NEUTRAL] OK. And what I can do is, um,
[CUSTOMER][NEUTRAL] I can, uh, I've got to call in to Doctor [PII] anyway on something else. Um, I can have them fax those over to you, if need be.
[AGENT][NEUTRAL] Yeah, but it most likely, probably most likely have to wait till they get the request with our authorization form that you signed giving us permission to get those medical records, uh, but I'm not for sure, but I just do know we need medical records between [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Ah.
[AGENT][NEUTRAL] She's looking, OK, cause anything before that, anything after that, we can't use, it has to be before we'd have to be within the 12 month period that you took out the policy to um before you took out the policy, yes, ma'am. She looking, she gonna, I am in a minute and tell me.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] OK. Well, maybe she, maybe she's already gotten them.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] No, she just did it on the [PII], so that, that [PII] was uh on Wednesday, so they probably ain't even got it yet, uh.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] 00, OK, OK.
[CUSTOMER][NEUTRAL] Yeah, yeah, yeah.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Oh, they mail them out.
[AGENT][NEUTRAL] We faxed them or mail them and I'm not sure how she's seen it. We faxed them or we mail them, uh-huh.
[CUSTOMER][NEUTRAL] The request.
[CUSTOMER][NEUTRAL] Fax
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Most likely they don't let you email them for the medical record. They won't email the medical records to either to us either because you know the HIPA line stuff oops let me upload and see uh she sent it to uh to Sono S O I N E dermato dermatologist. That's who she asking them for.
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][NEUTRAL] The hip, yeah, the HIPA.
[CUSTOMER][NEUTRAL] Dermatology.
[AGENT][NEUTRAL] That's what she said. That's what she got on here. I don't know. Maybe she, let me make sure she got the, let me.
[CUSTOMER][NEUTRAL] What?
[CUSTOMER][NEUTRAL] Yeah, cause I haven't seen any dermatologists.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] I mean, I'm, I'm writing a back.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Well, I'm glad I called.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] She she what she put on the list.
[AGENT][NEUTRAL] Let me make a copy of your list that you sent, but she can see that. Give me one second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Copy.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Let me have your number and I'm gonna let her call you back. What's that number?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK. It's [PII].
[AGENT][NEUTRAL] OK, and if she don't call you back I'll call you back, but let me, let me find out I won't be holding you on the phone and I'll get one of us will give you a call right back, let you know what's going on.
[CUSTOMER][POSITIVE] OK. OK, thank you.
[AGENT][POSITIVE] Thank you. You're welcome, Ms. [PII]. Bye.
[CUSTOMER][NEUTRAL] And