AccountId: 011433970860
ContactId: e02f65df-a83f-4f8a-9011-69325730ad62
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 294739 ms
Total Talk Time (AGENT): 82036 ms
Total Talk Time (CUSTOMER): 112049 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/26/e02f65df-a83f-4f8a-9011-69325730ad62_20250226T17:04_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, this is [PII] with the Aris Group, and I'm calling to get an update on some claim information we submitted in for one of our policyholders.
[AGENT][NEUTRAL] OK, I can verify that for you, Ms. [PII], and what's the policy number, please?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Policy number is.
[CUSTOMER][NEUTRAL] 243-515-5. [PII] and it's a critical illness claim on her son [PII].
[AGENT][NEUTRAL] OK, let's see, and Ms. [PII], do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yep, [PII].
[AGENT][NEUTRAL] OK, and you said it's for [PII], do you have his date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII]'s date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you, ma'am. Give me one moment, please.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] And you say you're calling from the broker's office?
[CUSTOMER][NEUTRAL] Yep.
[AGENT][NEUTRAL] OK, let's see.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] S
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. It looks like the claim is received and looked like it was uh processed as needing the itemized billing and uh medical records.
[CUSTOMER][NEUTRAL] OK, we sent additional information in. Did you receive additional information?
[AGENT][NEUTRAL] Uh, when was that sent?
[CUSTOMER][NEUTRAL] And who are, are you?
[CUSTOMER][NEUTRAL] I mean it's it's been at least 2 weeks ago.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, let me see if I can get an examiner for you, Ms. [PII]. Hold on one quick moment for me, please.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Oh, you're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Referring.
[CUSTOMER][NEUTRAL] Thank you for calling APL. You're speaking with [PII]. How may I help you today?
[AGENT][NEUTRAL] Hey [PII], um, I have [PII] with the broker's office calling about a claim status for a patient, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Policy number 243-5155.
[AGENT][NEUTRAL] And I tell her it looks like on this, oh, it's just for part 4.
[CUSTOMER][NEUTRAL] OK, let's go to 4, OK.
[AGENT][NEUTRAL] Uh.
[AGENT][NEUTRAL] And I told her it looks like we were needing additional information, but she is stating that they have already sent that and want some um help as far as this claim.
[CUSTOMER][NEUTRAL] OK. Let me see, let me see what that, that denial saying.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. And this is done by [PII]
[CUSTOMER][NEUTRAL] And let's see what she needing.
[CUSTOMER][NEUTRAL] Uh, need itemized bill. OK, need itemized bill.
[CUSTOMER][NEUTRAL] Or medical records for your claim receipt or your claim is I need automatic bill or medical records for your claim receipt of your claim I have in order to provide further consideration of your claim, we need the itemized bill for treatment receipt and medical records for this data center. OK. uh, let me go over to the claim, which, and this is [PII] with the broker office.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, uh, I would speak with and tell him what, what, uh, you know, you're saying that they would know saying tell what they need. OK, you can let me speak to him.
[AGENT][POSITIVE] Awesome. Thank you, Ms. [PII]. Have a great day.
[CUSTOMER][POSITIVE] OK, thank you, [PII].
[AGENT][NEUTRAL] Bye.