AccountId: 011433970860
ContactId: fdb4c351-b8f6-4840-8061-db6c22088068
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 279200 ms
Total Talk Time (AGENT): 77634 ms
Total Talk Time (CUSTOMER): 198263 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=-0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/fdb4c351-b8f6-4840-8061-db6c22088068_20250605T13:05_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi sir, good morning. This is [PII] calling. I'm calling. I wanted to see if you can confirm if they check either went out to me or to the urgent care. Um, I sent the, um, a message, um.
[CUSTOMER][NEUTRAL] The explanation of benefits I sent it out like I did it online so I just wanna make sure that everything's up to par.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, let's take a look. What's, do you have your policy number?
[CUSTOMER][NEUTRAL] Uh, you need
[CUSTOMER][NEUTRAL] Do you need the outpatient? Yeah, I got the outpatient benefit number. Is that what you need?
[AGENT][POSITIVE] Yeah, absolutely, go ahead.
[CUSTOMER][NEUTRAL] OK. It's 013.
[CUSTOMER][NEUTRAL] 697-54 M like in Mary, L like in Larry and the number 8.
[AGENT][POSITIVE] All right, thank you. And then
[CUSTOMER][NEUTRAL] Uh, the data service is 26.
[AGENT][NEUTRAL] 26 of 25.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, and then if I could just verify please your date of birth and address.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Thank you. OK.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] I think I did it right. Normally I just fax it, but I don't know if I did it right.
[AGENT][NEUTRAL] Yeah. No, it looks like every
[CUSTOMER][NEUTRAL] It was a whole mumbo jumbo.
[CUSTOMER][NEUTRAL] They, they, there was one day to 2:10 because they didn't give me enough medicine. I was really sick. So I went to 6 and then they accepted, they, they accepted the secondary insurance, right? When I go to 10, they gave me a shit can nip and they were like, no, we're not taking it, blah blah blah. I think they're just stupid one day and not stupid the other day. And so I, I did, I did the 210. I mean, I was like, OK, and they said, well, we haven't gotten paid for 26. This was a little bit ago.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEGATIVE] And I was like, I was like, because you, it was just a, I don't know, I guess because the days were so close maybe they thought it was the same, but I, so I put this that you guys have stated that you guys didn't get an explanation of benefits and I was like, no, I think, you know, signa paid so I sent it to you guys. I don't know if I sent it right. I don't know if you guys sent the check to me or to them. I don't care which room you send it to, but I know I haven't received it, so I just wanna make sure for 26 service.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right. OK.
[AGENT][NEUTRAL] Yeah, so the date for 26 was processed and paid to the provider, so they got a check sent to them, um, and that was sent to them on [PII], so I feel like they should have it by now, um, because that's been a few weeks ago.
[CUSTOMER][POSITIVE] OK, good.
[CUSTOMER][NEGATIVE] OK, alright, I just couldn't figure out how you guys gonna get the expiration of benefits like paper of signal. It's a nightmare going back and forth with this one little situation. So you said you sent it, so you're good. It's OK. It's not your fault, and I was like, maybe because of the dates were so close, not your fault, but what I do not understand is, um, when they wouldn't take it on to [PII], I had to end up you guys sent me money and I end up sending it to them.
[AGENT][POSITIVE] Oh, I'm sorry.
[AGENT][NEUTRAL] Mhm, mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Oh, yeah.
[CUSTOMER][NEGATIVE] When they wouldn't take it, I had, cause I had to pay them. Like, I literally had to pay out of pocket and I was so pissed off but I called you guys cause I was like, you know, I said, and, and I go to the same urgent care. It's not like I go frequently, but I've gone there. So, and I was like, OK, so I called you guys and then the girl on the phone was like,
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] It's not like a confirmation number or something that you guys can do. It's just you guys cover it's like not a big deal and it's so difficult with some of these places because they're like, you know.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Give issues. I don't know if you guys are gonna change your ways of how you, you know, do things like, OK, this is our proof, but I couldn't give them any proof even with having you guys on the phone. I don't know what to do.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][MIXED] It's alright as long as you cover it, that's perfectly fine, but I'm happy you sent it out so that should be squared away then hopefully they don't complain they didn't get anything they do then.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, hopefully they don't give you, yeah, they don't give you a hard time because they should have gotten all that. So it should be straightened out, OK?
[CUSTOMER][NEUTRAL] You know, I'll let you guys know.
[CUSTOMER][NEUTRAL] Uh, can you tell the check cleared or not or you can't say that.
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] Uh, yeah, it looks like it's been cashed.
[CUSTOMER][POSITIVE] Perfect. Then you can't complain. Alright, thank you. I appreciate all your help. All right.
[AGENT][POSITIVE] You're, you're welcome, [PII]. Have a good day.
[CUSTOMER][POSITIVE] You too thanks bye bye.
[AGENT][NEUTRAL] Right.