AccountId: 011433970860
ContactId: e647d3c3-c27b-4c0a-9508-bc2d794b5212
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 476500 ms
Total Talk Time (AGENT): 212618 ms
Total Talk Time (CUSTOMER): 152717 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/10/e647d3c3-c27b-4c0a-9508-bc2d794b5212_20250410T21:11_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Alright and I have a claim number.
[AGENT][NEUTRAL] OK, may I have your name?
[CUSTOMER][NEUTRAL] OK, it's [PII]
[AGENT][NEUTRAL] And Ms. you need um help with like a claim status?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you for that and the claim number?
[CUSTOMER][NEUTRAL] 358-755-52
[AGENT][NEUTRAL] You um the phone kind of went in and out, you said 358-755-2. OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Hold on one moment, it's coming up now.
[AGENT][NEUTRAL] All right, and I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] Sure, [PII], um, uh, emails [PII]. It's for my husband [PII].
[AGENT][NEUTRAL] Thank you, and your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you for that and I'll
[CUSTOMER][NEUTRAL] What is what your calendar look like for interviews for when it's just any time so I can tell I can't.
[AGENT][NEUTRAL] And all the information.
[CUSTOMER][NEUTRAL] Maybe next week, uh, this week I don't know.
[CUSTOMER][NEUTRAL] Tomorrow's fine and uh
[CUSTOMER][NEUTRAL] Monday looks fine. OK, tomorrow and Monday, yeah, Tuesday and um this other days in case Tuesday he's really, he really, yeah, mhm, yeah, yeah, OK, let's see if I can.
[CUSTOMER][POSITIVE] And Wednesday, Wednesday's good. Mhm, I'm sorry, ma'am.
[AGENT][NEUTRAL] It's OK. All the information provided is a verification of benefits, not a guarantee of payment. And um what questions did you have in reference to this claim?
[CUSTOMER][NEUTRAL] OK, is it being paid? What's going on with?
[AGENT][NEUTRAL] Oh, yes, ma'am. Um, hold on one moment. It looks like it just finished processing either yesterday or today because it just has a generic date of [PII]. So that lets me know they just finished processing um and there's a payment of $1100 being sent to you now. Since it just finished processing, it shows as a check, but um,
[AGENT][NEUTRAL] I see here that you have direct deposit. So once it, once midnight hits, that's when everything is sent to the bank, so this will switch over.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so $1100.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK thank you and I'm still waiting on the other accident. Can you check on that for me?
[AGENT][NEUTRAL] Mhm. You said it's an accident or it's the same policy? OK.
[CUSTOMER][NEUTRAL] I can't give you the policy.
[CUSTOMER][NEUTRAL] No, it's an accident, 254-585-1.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] OK, I have a claim that came in on [PII] and then one on [PII]. Um, which one would it be?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]? OK, hold on one second.
[AGENT][NEUTRAL] OK, so this one was denied on today. Um, it's asking for the itemized hospital bill with the admission and discharge dates and times.
[CUSTOMER][NEUTRAL] OK, so I need to send.
[CUSTOMER][NEUTRAL] What do I need to send them?
[AGENT][NEUTRAL] Um, an itemized bill, um, the hospital may also call it a universal bill, um, but it needs to have the admission and discharge dates and times.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] When was that, um, denied?
[AGENT][NEUTRAL] It was just the night today, [PII].
[CUSTOMER][NEGATIVE] OK, because I called, I don't even see it up here anymore um under my claims and when I called earlier she said she was gonna give it back to the adjuster. I wonder if it's after that she gave it back to the adjuster.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Give it back to the adjuster for what was needed at that time.
[CUSTOMER][NEUTRAL] To to review it because all the stuff was there.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] I'm gonna say it was after. The only thing that I see is the notes from yesterday when you spoke with [PII], um.
[AGENT][NEUTRAL] But the claim just finished processing today.
[AGENT][NEUTRAL] So after they reviewed everything, the itemized bill with the admission dates and times are still needed.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] OK, so where do I send that?
[AGENT][NEUTRAL] Um, you can upload that to the online service center, um, where you upload the claims, you can fax it or you can mail it to us.
[CUSTOMER][NEUTRAL] Do I have to send fill out another claims file?
[AGENT][NEUTRAL] No, not for this, because it's additional information. Um, you can just upload the, the billing that your uh doctor or the hospital gives you.
[CUSTOMER][NEUTRAL] But it
[CUSTOMER][NEGATIVE] But it's not, but it's not even um.
[CUSTOMER][NEGATIVE] It's not even there. I mean, it's not even.
[CUSTOMER][NEUTRAL] I'm confused because it's not um
[CUSTOMER][NEGATIVE] The claim isn't even on here yet. I mean it's not even, you know, where you could see my claims it's not even there anymore.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] So you have to
[AGENT][NEUTRAL] Yeah, so since they just finished processing today, you'll have to give it until [PII]. At [PII], everything is gonna go to the banks and upload to the online service center. You just call before everything popped up again.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright thank you so much.
[AGENT][NEUTRAL] But you, you're welcome, um, but you can go ahead and reach out to the hospital to get that form. If you don't have to fill out a new claim form, but when you submit it, it is going to give you like a new claim number and confirmation number, but that just lets you know you did it correctly, anytime you submit it, it's going to look like a new claim, but we know it's for what's already here.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] So uh what do you need again?
[AGENT][NEUTRAL] So you'll need the itemized bill with the admission and discharge dates and times.
[CUSTOMER][NEGATIVE] Why y'all didn't need that for the hospital indemnity? Cause it's the same thing and y'all paying that.
[AGENT][NEUTRAL] It's two different policies, two different policy types, and we have to provide different information if we're audited, so we just have to make sure we have it on file.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] You're welcome. Well, was there anything else I can assist you with today?