AccountId: 011433970860
ContactId: ec2a6666-0782-4709-8f9e-600f46c23f70
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 497980 ms
Total Talk Time (AGENT): 145918 ms
Total Talk Time (CUSTOMER): 156011 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/ec2a6666-0782-4709-8f9e-600f46c23f70_20250325T21:37_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, I'm actually calling to follow up on um the pay uh payment for one a claim that I submitted.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] OK, is it for yourself or you as a provider?
[CUSTOMER][NEUTRAL] For myself.
[AGENT][NEUTRAL] OK. Um, can I get your name and a good callback number?
[CUSTOMER][NEUTRAL] Um, the name is [PII]. Last name is [PII]
[AGENT][NEUTRAL] And your number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Do you have your policy number?
[CUSTOMER][NEUTRAL] Um, I do, yes.
[CUSTOMER][NEUTRAL] It's 025.
[CUSTOMER][NEUTRAL] 919-6.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Hold on.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, I'm sorry, 0259196?
[CUSTOMER][NEUTRAL] 02591091961.
[AGENT][NEUTRAL] 961. OK.
[AGENT][NEUTRAL] And was it a claim for yourself?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Uh, I just need you to verify just a few more pieces of information if you don't mind. Um, what's your address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And your email address.
[CUSTOMER][NEUTRAL] Um it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you so much, [PII]. Um, OK, so what was the date of service for that claim?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] Thank God, it's been a while. It's been a while.
[CUSTOMER][NEUTRAL] Uh, the date of service [PII].
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] Uh, I'm pulling that up, if you'll give me just one moment.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Uh, it looks like we had processed this and, and in order to complete the processing we need itemized statement of service provided listing the charges, diagnosis code and procedure.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Code
[CUSTOMER][NEUTRAL] Right, and I sent that and I sent that to you.
[AGENT][NEUTRAL] OK, when did you send that?
[CUSTOMER][NEUTRAL] And I said I sent, I sent that to you, um, and I got confirmation it went through on [PII].
[CUSTOMER][NEUTRAL] I went back to the doctor and they, yeah, yeah, [PII].
[AGENT][NEUTRAL] [PII], OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I sent all that information.
[AGENT][NEUTRAL] OK, let me see where we're at.
[AGENT][NEUTRAL] Let me make sure we received it first.
[AGENT][NEGATIVE] Sorry, my system is running a little bit slow.
[CUSTOMER][NEUTRAL] I sent it um I was told because it was taking so long uh I sent it, uh, I emailed it.
[CUSTOMER][NEUTRAL] To, um, claims team and uh.
[CUSTOMER][NEUTRAL] I forgot what what it was and they said um.
[CUSTOMER][NEUTRAL] That they would
[CUSTOMER][NEUTRAL] They would send it to to to the claims, uh, the claim section.
[AGENT][NEUTRAL] OK, let me see what we've got here.
[CUSTOMER][NEUTRAL] Uh, the, the, the care team, I said the care team at [PII] and they said because it's taken so long they would make sure it got to the claims department.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Let me reach out to our care team um and see what's going on, and you said you sent that on [PII] is that correct? And you got confirmation.
[CUSTOMER][NEUTRAL] Yes, I did get confirmation. Yeah, I mean this is like been a crazy process I have to tell you I I can't believe how long it's taking.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, yeah, I'm sorry about that. I definitely don't want it to be like that. Um, let's see.
[AGENT][NEUTRAL] Cause I, I don't see, I, I see the original fax that was received on [PII].
[AGENT][NEUTRAL] But I'm not seeing.
[CUSTOMER][NEUTRAL] No this was
[CUSTOMER][NEUTRAL] Because I, because I emailed it to this care, I, I emailed it to the care team that's what I was told to do.
[AGENT][NEUTRAL] Your
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, we have a database where we load everything though and I'm not actually finding it in that either, so I'm.
[AGENT][NEUTRAL] Trying to figure out what's, what's going on here. Um.
[AGENT][NEUTRAL] So let me reach out to our care team um is that is the [PII] is that a good.
[AGENT][NEUTRAL] Good number to reach you back at [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes it is.
[AGENT][NEUTRAL] OK, uh, if it's not today, what's your, what's good hours for you tomorrow?
[AGENT][NEUTRAL] So that I can contact you.
[CUSTOMER][NEUTRAL] Any, any time is, is there, is it possibly to get a call back today or?
[AGENT][NEUTRAL] Um, I, yes, I'll reach out to the care team and have them research, um, and it's possible, yeah, um, they're here until [PII], so hopefully they should be able to respond back to me pretty quickly.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And did you submit an itemized statement? like what what did you submit? Was it like a statement from your physician?
[CUSTOMER][POSITIVE] Yes, I submitted everything they.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I submitted everything they asked me to submit it's um it was.
[CUSTOMER][NEUTRAL] I mean, obviously the receipt of payments, it would be um.
[CUSTOMER][NEUTRAL] The reason for the appointment, the history, um.
[CUSTOMER][NEUTRAL] The ba ba ba ba ba. Let's see, um, there was some coding that they asked for.
[CUSTOMER][NEUTRAL] It was a couple
[CUSTOMER][NEUTRAL] Um, assessments, uh.
[CUSTOMER][NEUTRAL] The codes
[AGENT][NEUTRAL] OK, and just to confirm again that was for you as the patient, not for your spouse, correct?
[CUSTOMER][NEUTRAL] I guess that's the code.
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] OK, OK, let me reach out to them right now and let them know it's an urgent request and then hopefully I can call you back today, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect thank you very much.
[AGENT][POSITIVE] OK, thank you so much.
[CUSTOMER][NEUTRAL] OK bye bye.
[AGENT][NEUTRAL] Bye.