AccountId: 011433970860
ContactId: f0a10274-06e1-4b97-aead-153db0a853ec
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 280049 ms
Total Talk Time (AGENT): 60111 ms
Total Talk Time (CUSTOMER): 167389 ms
Interruptions: 3
Overall Sentiment: AGENT=0.4, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/03/f0a10274-06e1-4b97-aead-153db0a853ec_20250603T19:04_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Hi, good afternoon, [PII]. Um, my name is [PII], and um I'm calling about a particular claim. Um,
[CUSTOMER][NEUTRAL] Uh, I guess you will need my group number.
[AGENT][NEUTRAL] Um, policy number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Or the pay ID number, which one is it?
[AGENT][NEUTRAL] Um, how about your social?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and what's your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And if you can verify the email address.
[CUSTOMER][NEUTRAL] Uh, it's my name, [PII].
[AGENT][NEUTRAL] Thank you for that and this is in regards to a claim and what's the date of service for the claim?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, this would have been back in [PII].
[AGENT][NEUTRAL] And how can I assist?
[CUSTOMER][NEUTRAL] So I got this invoice from, uh, well, to begin with, I had COVID last year, um, September, um, it was for a couple weeks and it was really bad and I had to end up a little hospital emergency room, so I went to West Side. I mean, I didn't, I only spent a couple hours there. It wasn't all day or anything, but anyways.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] Bottom line is there was an out of pocket of 1750 that United did not cover.
[CUSTOMER][NEGATIVE] And they're saying that they tried to reach out to EPO between December to April they've been trying and they haven't been successful to get through to you all and they gave me a claim number.
[CUSTOMER][NEUTRAL] Um, maybe I can give it to you.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It is 352-687-5.
[CUSTOMER][NEUTRAL] Then I'm like, OK, and then she asked for all my financials and all that stuff, so we sent her like a whole list of what we learn, yeah, and then.
[AGENT][NEGATIVE] OK, so that looks like they filed the claim but they didn't send the EOB from your primary insurance and we asked for that and we never got it back.
[CUSTOMER][NEUTRAL] That's
[CUSTOMER][NEUTRAL] Oh, so, OK, so I guess I have to go into United.
[AGENT][NEUTRAL] No, actually, actually, what I'm sorry, wait, wait, wait, wait.
[AGENT][NEUTRAL] Hold on one second.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 2
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] What.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Yeah, OK, so.
[CUSTOMER][NEUTRAL] I got started
[AGENT][NEUTRAL] OK, and then they sent a claim the claim back.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Do the air.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] And they still didn't send it back, so it denied for a duplicate because they didn't send.
[AGENT][NEUTRAL] Um, they still didn't send the um explanation of benefits from your primary insurance.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, so I need that from United OK.
[CUSTOMER][NEUTRAL] OK, so I can once I get that I can submit it online?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] With the claim number? OK. All right.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK doke.
[CUSTOMER][NEUTRAL] Uh, I think I should be able to get that. Let me go and see if I can fix that.
[CUSTOMER][POSITIVE] All [PII]. Thank you so much. I appreciate it, [PII].
[AGENT][NEUTRAL] OK, was there anything else I could assist with today?
[CUSTOMER][NEUTRAL] Um, but before you go though, um, because they told me they, they have the bill on hold for only 10 days, so I, I don't want to go to collection, so I just wanna have an idea of how long it'll take to settle once you get the claim.
[AGENT][NEUTRAL] Um, our normal processing time is 7 to 10 business days, so we normally process in less than that.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] 7 to 10. So, uh, OK, so I'll ask them to hold until it's processed. OK, alright, thank you, [PII]. I appreciate it.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Well thank you for calling APL. You have a good day.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Mhm.