AccountId: 011433970860
ContactId: f4f2cd13-f2b6-4beb-8235-69aabe11271b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 250580 ms
Total Talk Time (AGENT): 83160 ms
Total Talk Time (CUSTOMER): 160546 ms
Interruptions: 1
Overall Sentiment: AGENT=1.6, CUSTOMER=-0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/25/f4f2cd13-f2b6-4beb-8235-69aabe11271b_20250225T19:19_UTC.wav
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[AGENT][POSITIVE] Good afternoon thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, [PII]. My name is [PII]. Um,
[CUSTOMER][NEUTRAL] I have a claim that was denied for um you guys need an itemized bill with the admission and discharge dates and times which the hospital didn't have that on their UB and will not so um they were to fax medical records over to you and I'm wondering if you received them yet.
[AGENT][POSITIVE] Well, it would be my pleasure. I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] I called
[CUSTOMER][NEGATIVE] I said I've called you guys several times. I talked to [PII] on [PII], and she hadn't received them, so I called the hospital again. They were supposed to send them.
[AGENT][POSITIVE] It would be my pleasure to check that for you, Ms. [PII]. Do you have your policy number available?
[CUSTOMER][NEUTRAL] It is 02435427.
[AGENT][NEUTRAL] Thank you, Ms. [PII]. And can you verify your date of birth and current mailing address?
[CUSTOMER][NEUTRAL] [PII] and it's [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] Is this for your hospital indemnity policy?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Was this from 2024?
[AGENT][NEUTRAL] For April
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Back in April, yes.
[AGENT][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I'm showing that we did pay $100 but that and that was back on, that's, I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] No, that was
[CUSTOMER][NEUTRAL] I know that that was for the ER physician. I'm talking for the hospital bill for the, for the facility, you guys, the UB that [PII]'s provided did not have admission and discharge at the time. So [PII] said that the medical records would suffice beca and so [PII]'s has been supposed to send the medical records to you.
[AGENT][NEUTRAL] Got you, for your facility.
[AGENT][NEUTRAL] Um.
[AGENT][NEUTRAL] The short time.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEGATIVE] And we have not received them yet.
[CUSTOMER][NEGATIVE] That's ridiculous. And then the other day in the mail, I got a little CD that has the X-rays of my knees and stuff, so I don't know what's going on there.
[AGENT][NEUTRAL] You're like, why did they send that to you, right?
[CUSTOMER][NEGATIVE] Yeah, I'm getting a little frustrated because I work in healthcare. I pay claims myself, so.
[AGENT][NEUTRAL] So you understand exactly what's needed, don't you?
[CUSTOMER][NEUTRAL] Alright, I'll just.
[CUSTOMER][NEGATIVE] Oh yeah, yep, so I'm getting a little frustrated and our system happens to be down it's hard for me to make calls when I'm working and so anyway, um.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] I'll just have to call [PII] again, so thank you so much.
[AGENT][NEUTRAL] And if you need to, just uh, I mean, I'll, you're probably familiar with everything too, but sometimes just speaking to a supervisor that you've requested those medical records several times.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEGATIVE] Yeah, and that lady hasn't even called me back the last few.
[AGENT][NEUTRAL] Oh, really? So you've tried that.
[CUSTOMER][NEGATIVE] Yeah, I've tried everything, so I'm getting a little frustrated.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Bless your heart. I'm so sorry. That is frustrating.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] Uh it's very frus like I said, I, I'm on production. Our, our system went down today and hadn't come back up and we're, I'm having to take unscheduled PTOs. So I'm like, well, I'll call while I can. So, all right, well, I'll call [PII] again. I thank you for your help.
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] They don't have a portal, do they? where you might get some information from a portal?
[CUSTOMER][NEUTRAL] Well, you can't pull your, I mean, I can't, I can't send my, that would be, you know, HIPAA if I tried to send.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, that's true.
[CUSTOMER][NEGATIVE] You know, so can't do that.
[AGENT][NEUTRAL] Yeah, I was just trying to think of something for you.
[CUSTOMER][NEUTRAL] So there's taxes.
[CUSTOMER][POSITIVE] I know, well, I appreciate it and um.
[AGENT][POSITIVE] My pleasure, Ms. [PII].
[CUSTOMER][NEUTRAL] Today
[AGENT][POSITIVE] I hope you have a wonderful day as well.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] Alright, thank you.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.