AccountId: 011433970860
ContactId: fda77a2a-3ea4-477d-b62a-3c1acf0d80e2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 581520 ms
Total Talk Time (AGENT): 316087 ms
Total Talk Time (CUSTOMER): 381457 ms
Interruptions: 24
Overall Sentiment: AGENT=1.1, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/fda77a2a-3ea4-477d-b62a-3c1acf0d80e2_20250207T19:19_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APO. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII], and I was calling to check on a claim. I noticed, um, I had a couple of claims that were processed and I had one of them was direct deposited days ago and the other one hasn't been.
[AGENT][NEUTRAL] OK, Miss [PII], so the claims are for yourself and you're just wanting to check on the status as far as you said you saw one was direct deposited.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, I've already gotten the one, but the $6000.01 has not been.
[AGENT][NEUTRAL] But the other has not there?
[AGENT][POSITIVE] Yes, ma'am. I can help you with this. And uh-huh, I can take a look at this for you, Miss [PII]. And what is the callback number for you?
[CUSTOMER][NEUTRAL] I just.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, and your policy number, please?
[CUSTOMER][NEUTRAL] Uh no I just.
[CUSTOMER][NEUTRAL] My what? My what? Oh, I don't have that on me. Uh, let me see. I'm, oh, let me see. I might have that in my purse. Can you do it with my social?
[AGENT][NEUTRAL] Your policy number?
[AGENT][NEUTRAL] Yes ma'am, is the policy in your name, Miss [PII]?
[CUSTOMER][NEUTRAL] That's.
[CUSTOMER][NEUTRAL] Yes, it's in my name and the claims were on my husband.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so what is your full social?
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you. Give me a moment, please.
[CUSTOMER][NEUTRAL] Oh it's uh, I understand that now.
[CUSTOMER][NEGATIVE] It takes longer stay.
[CUSTOMER][NEUTRAL] And it's legally required that.
[CUSTOMER][NEUTRAL] On the way.
[CUSTOMER][NEUTRAL] 80% of your customers with that.
[AGENT][NEUTRAL] OK, so first off, Miss [PII], any information that I do provide for you would be a verification of benefits and not a guarantee of payment. What is, um, I will need to verify several things with you first for security. So first off, if you'll please verify your date of birth and also your husband's name and date of birth.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] And I have is uh no those researching. I mean all that is is you know you send documents. OK, min is 33,070. His is [PII] 122,270. [PII].
[AGENT][NEUTRAL] Thank you. The home mailing address, please?
[AGENT][NEUTRAL] Thank you. The phone number we have for you is also the same as the one that you gave me, so that is your best contact number, is that correct?
[CUSTOMER][NEUTRAL] Every single time I.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you. And lastly, your email address, please?
[CUSTOMER][NEUTRAL] I think the song was part of the.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] I just
[AGENT][NEUTRAL] All right, so under your currently active policy, the most recent claim that was processed, there's only one claim currently under your active policy that went into effect [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] they, they have to do.
[CUSTOMER][NEUTRAL] and you're talking.
[CUSTOMER][NEUTRAL] That.
[AGENT][NEUTRAL] I can see that that one did process on [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And this one is was a check instead of a direct deposit for $6250.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, OK, because the other one came in direct deposit. I don't know why the 6000 didn't, but.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] So let me look.
[CUSTOMER][NEUTRAL] Because there was another one for [PII] for the same day and it, it went in.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK, so let me look. I think, give me just a moment, Ms. [PII] to look at just a couple of things.
[CUSTOMER][NEUTRAL] I was
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I work out.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEGATIVE] sorry.
[CUSTOMER][NEUTRAL] The
[AGENT][NEUTRAL] OK, Ms. [PII]. So the reason it did not go this time, but we will get it added back in.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] I also have
[AGENT][NEUTRAL] The, the policy number that you had assigned to your coverage before this one.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It had your direct deposit information on there, but this claim that was issued via check for the 6250, when this policy was issued, that ACH information did not pull over into this new policy. So if you will.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] uh.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] might be.
[CUSTOMER][NEUTRAL] So that's weird. Why did the other one?
[CUSTOMER][NEUTRAL] The one the other one for the same day for [PII].
[CUSTOMER][NEUTRAL] Was direct deposited on the same policy.
[AGENT][NEUTRAL] And we
[AGENT][NEUTRAL] Well, there's only one claim for your husband under the policy that has the $6250 paid.
[CUSTOMER][NEUTRAL] this.
[CUSTOMER][NEUTRAL] See, that's weird. I filed one claim and it was divided into two for some reason, one for the November day, uh, hospitalization and one for the December hospitalization, so.
[AGENT][NEUTRAL] Right, because the one that was direct deposited for the [PII], that data service was 1125 to 27. So it was under that previous policy number. That policy number, that policy number was active from 91 to 121.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Oh, that's weird. OK.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] And then when
[AGENT][NEUTRAL] When you were issued the new policy number effective 121 that's currently active now, that's why it was one claim was processed under one policy and the other one was processed under the.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] You know, to, to coincide with that data service, right, because the one for the 6000 benefit has a data service, it looks like a 1211.
[CUSTOMER][NEUTRAL] Either one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I see.
[CUSTOMER][NEUTRAL] Uh-huh, yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You know, date after [PII]. So that's why, but I will make sure, um, to get, have that information added back to this new profile for your, I mean, your new policy number.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, OK.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Yeah I'm hoping that by the end of February. OK.
[CUSTOMER][POSITIVE] OK, good. And
[AGENT][NEUTRAL] So that moving forward that should be there.
[CUSTOMER][NEGATIVE] OK, good, and I know on that one I have been having the hardest time on a claim we did on the other policy before and on this one to get surgeon bills like it's all tied up in the hospital for some reason and I keep going there trying to get a surgeon bill and they were like oh well you don't know what you're talking about so I don't know how to get that.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, um,
[CUSTOMER][NEUTRAL] Uh, cause I think there's part of that on that claim that was processed said, you know, provide the surgeon.
[CUSTOMER][NEUTRAL] Uh, bills for further.
[CUSTOMER][NEUTRAL] A consideration or something like that.
[AGENT][NEUTRAL] Let me
[AGENT][NEUTRAL] Yes, ma'am. So, I mean, we will have to have that itemized bill. They should be able to provide, the facility should be able to provide the itemized surgery bill.
[CUSTOMER][NEUTRAL] That's what I thought.
[CUSTOMER][NEUTRAL] You know how they give you the run around. I'm like, come on people. Well, I, it's this office, no, and then you go to that office, no, it's this office. I'm like, oh people, please. It's not a small place.
[AGENT][POSITIVE] I'm so sorry.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Right, right.
[CUSTOMER][NEUTRAL] So, OK. All right, well, I'm still trying to get that from a previous one.
[AGENT][NEUTRAL] Um, now, have you?
[AGENT][NEUTRAL] And have you contacted the surgeon?
[CUSTOMER][NEUTRAL] Um.
[AGENT][NEUTRAL] That performed her husband's.
[CUSTOMER][NEGATIVE] I can't get the name. I asked them who the surgeon was, and they aren't telling me this, the name. It's ridiculous. I'm like, why is that a secret? It's almost like they don't know who did it and that's kind of scary.
[AGENT][NEUTRAL] Oh.
[AGENT][NEGATIVE] Now, that is odd. That is odd that they wouldn't be able, that should be in his medical record information, which obviously, you all are entitled to.
[CUSTOMER][NEUTRAL] Well, and they keep, oh, you know what, do you know the surgeon for that pericardial window. I could find, I should have done that today. We were there today, um, asking them about that. I do know that one, but the one from a few months ago, I've been trying, it's just I can't get anyone on that one. No one knows who did his biopsy.
[CUSTOMER][NEUTRAL] The name of the guy that did the biopsy in July. That's what, so anyway.
[AGENT][NEUTRAL] That should be under, I mean, I would think, I would, I would think, Ms. [PII], that that would be indicated on his pathology report as to
[CUSTOMER][NEUTRAL] Not
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Who read that?
[CUSTOMER][NEUTRAL] OK, I'll have to get that then. We don't get all that stuff all the time, OK.
[AGENT][NEUTRAL] But yes, ma'am. I mean. Right, right. No, sure. And hopefully, you know, I mean, obviously, you don't wanna have to try to be getting this type of information, you know, really kind of ever, I guess. But um and I know it is very complicated this day and time. It's not a matter of just one phone call, unfortunately.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right, right.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK. All right, well, I guess I'll be watching the, the uh mail then for that check.
[AGENT][NEUTRAL] But um,
[AGENT][NEUTRAL] Yes ma'am, and so it went through our processing on the [PII] on [PII], so that means the check wouldn't have been mailed out at least and I mean for sure until the [PII] could have possibly even, you know, been the [PII], um, but I would think it was probably the [PII], but again, and it's about 10 business days or so to receive that typically.
[CUSTOMER][NEUTRAL] Uh, for that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, thank you so much.
[AGENT][POSITIVE] OK. Well, you are certainly so welcome. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, that's it.
[AGENT][POSITIVE] OK, well then, thank you for calling APL and I hope that you have a very nice weekend.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][POSITIVE] All right you too.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Uh huh bye bye.