AccountId: 011433970860
ContactId: e78428d0-b2d0-4d12-8110-e887f66beebf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 349579 ms
Total Talk Time (AGENT): 183444 ms
Total Talk Time (CUSTOMER): 140707 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/e78428d0-b2d0-4d12-8110-e887f66beebf_20250313T13:30_UTC.wav
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[AGENT][POSITIVE] Thank you for contacting APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, um, I had tried to submit some recent claims, but I was having some technology issues and wasn't able to get one of my forms.
[CUSTOMER][NEUTRAL] And, but I think it already got like processed before I just got to upload it today so I just kinda wanted to check the status of where all of that was at.
[AGENT][NEUTRAL] Yes, I can certainly look at the claim and with whom am I speaking please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Sure, thank you. What is your policy number that I can look it up today?
[CUSTOMER][NEUTRAL] Yeah, 1 2nd.
[CUSTOMER][NEUTRAL] OK. It's 02515497.
[AGENT][NEUTRAL] Thank you. And if I could just verify your um date of birth and the phone number, please.
[CUSTOMER][NEUTRAL] [PII] [PII]
[AGENT][NEUTRAL] Thank you. Let me see what we have here. It looks like 2 of them came through, so let's just look at this and see.
[AGENT][NEUTRAL] What uh
[AGENT][NEUTRAL] And whenever something like this happens, uh, if it, if it goes into two submissions, we usually just stick them together once we start processing.
[AGENT][NEUTRAL] So let me see what we have here.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Cause I got a text this morning saying that my claim was
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] What what does it say? My my claim is complete, but I didn't get to add the third document to it yet, so I didn't know if that was gonna like cause it to be denied.
[AGENT][NEUTRAL] Uh, let's see what we have here. That, that this is the first submission. It's uh 28 pages.
[AGENT][NEUTRAL] So, um,
[AGENT][NEUTRAL] OK, so there was something for, there was a lab bill.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] That came through
[CUSTOMER][NEUTRAL] Yeah, I think I submitted the um explanation of benefits in the claim form, but I was having trouble uploading my bill and so I just uploaded the bill this morning that has the procedure.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] He
[CUSTOMER][NEUTRAL] On it
[AGENT][NEUTRAL] Oh, right.
[AGENT][NEUTRAL] Now one of the things, OK, so that came through that that's not a problem there, so let me just look at this other, uh, let me see this other submission here really quickly. This is the second one.
[AGENT][NEUTRAL] So, uh, now one of the things that we will need um is a, uh, is the diagnosis code letting us know what the, what the labs were for, and, um, that's one of the things that they will be looking for, but let me just see. Now, I have another one that is 5 pages and uh that is also, OK, so it looks like your bills came through. Um, I'm not seeing a problem. Uh, it's just that, oh, let's see.
[CUSTOMER][NEUTRAL] Well, they, they did come through, but I didn't get my bill for that first one uploaded till this morning and that was after they said my claim is complete, so I didn't know if they already tried to look into it and processed it and maybe they would deny it because I didn't yet have the bill that had the procedure and diagnostic code because I wasn't able to get that.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Ma.
[AGENT][NEUTRAL] Right, I see that. Um, so yes, that one was already, uh, that one was already sent out, uh, yesterday, so we can't do anything about that. Uh, so what they will do is, um, it, uh, they will go ahead and uh look at this in, in conjunction with the, with the claim that was already processed. Uh, so there, there's that, that, uh, so we will look at it uh as a whole, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, but, um, but that other, that other claim, the one that was processed yesterday, with that, that one just has, you know, there's, it, it was, uh, you know, that that's already completed, so we can't do anything with that. So what we will do is once they, they, uh, once the examiners begin processing this, they're gonna look at this other claim, the one that was processed yesterday, and they will put all these documents together and then uh process it all as one.
[CUSTOMER][NEUTRAL] OK, so even though they already.
[CUSTOMER][NEUTRAL] Processed it, they'll, because there's the new piece in there, they'll like look at it all over again and then reprocess it. OK, good.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, that's exactly what will happen, yeah. Now is this, is this the only one that we are looking at? Uh, is there anything else at all that?
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] So there's, there should be two. So they're both from diagnostic labs. Um, so the, the one I had to send in 3 individual documents. That's why you guys had 2, but not the third one. but this morning, the second bill, I was able to put all 3 on the same claim.
[AGENT][POSITIVE] Yes, I see that and there shouldn't be a problem with that because what they'll do is they will just go ahead and look at them, uh, it does look like everything has come through, so that, that won't be a problem. They're going to put them both together, uh, even though they're, even though there are two submissions, they'll be processed as one.
[CUSTOMER][NEUTRAL] OK. Well, yeah, those were the only documents I had left to upload.
[AGENT][NEUTRAL] OK, good. Well, it looks like they came through. Um, now what we're doing right now is we're, we're working the claims that we received on the [PII] of this month. It usually takes 3 to 6 business days for us to, to process these. Um, if we don't get it done, uh, if we don't look at this, uh, by tomorrow, then it will be on Monday, and, um, then we'll see what we can do about getting this processed for you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK. Thank you so much.
[AGENT][POSITIVE] OK, well, um, thank you very much for contacting APL sir. You have a very good day.