AccountId: 011433970860
ContactId: fe184b51-5547-4e5d-b614-44a05fb340f3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 531080 ms
Total Talk Time (AGENT): 154276 ms
Total Talk Time (CUSTOMER): 120049 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/24/fe184b51-5547-4e5d-b614-44a05fb340f3_20250324T18:23_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes ma'am. I was calling about my claim and I had to send some additional uh information.
[CUSTOMER][NEUTRAL] And uh they gotten it but they, they didn't uh they said 0. Can you check it out for me?
[AGENT][NEUTRAL] Yeah, let's take a look. Do you have your policy number or claim number?
[CUSTOMER][NEUTRAL] Yes, yes, ma'am. It's 252-329-4.
[AGENT][POSITIVE] Thank you. And then if you don't mind, can I grab your first name and a good callback number?
[CUSTOMER][NEUTRAL] It's [PII] and uh it's [PII]. Last name is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And then I'll need to verify your date of birth and address, please.
[CUSTOMER][NEUTRAL] It's [PII] and the address is [PII].
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] And the claim itself, was it in your name?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So there were a couple recent claims on this policy. It looks like you submitted one around [PII] and then there was one on [PII]. Do you know which one it would be?
[CUSTOMER][NEUTRAL] Yes, well, uh, it was the one I, the.
[CUSTOMER][NEUTRAL] [PII], that's it, [PII].
[CUSTOMER][NEUTRAL] I think that one's it because that was uh the number that she gave me to put on my thing was 357-590-0.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't know if that helps you in.
[AGENT][NEUTRAL] OK, so that claim.
[AGENT][NEUTRAL] The 357-5900. OK.
[AGENT][NEUTRAL] So I'm showing that this claim was processed and paid.
[AGENT][NEUTRAL] Uh, looks like you have direct deposit set up, so you should have seen a benefit payment for $3,382.52.
[CUSTOMER][NEGATIVE] Right, now that one was paid, but they didn't pay me for, they didn't pay me for, uh, she said they they two of them they didn't pay me for which was for the dates of service of uh [PII] and then another one of [PII]. She said they didn't pay those because they didn't have the.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEGATIVE] The the sheets that I had the therapy, so those sheets is what I sent for that. They already had the explanation of benefits, but the, the two that they didn't pay me for.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, so that's what you had sent. OK. Did you
[CUSTOMER][NEUTRAL] Yeah, that's the two that I.
[AGENT][NEUTRAL] OK. Did you send it to us via fax or do you, how was it sent?
[CUSTOMER][NEUTRAL] Yes, I sent the fax and I put attention uh APL claim department.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me see.
[AGENT][NEUTRAL] I do see what you submitted. I see that we did receive that, so.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Hey.
[AGENT][NEUTRAL] OK, I need to go back, [PII] to the claim that did pay because it's saying explanation of benefits, but I see that you already submitted that so I'm trying to see if they just missed the date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Or um yeah.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, what I'm gonna do, [PII], is, um, reach out to the examiner that processed the claim because I see your explanation of benefits for the [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And just see if maybe they, you know, they missed it when you submitted the extra information because I saw that I see the claim number at the top um is this phone number the [PII], that's a good call back, right? The [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The [PII] yes ma'am.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] So, I'm just gonna kinda put in detail what's going on with the claim and that you kinda, you need a call back as far as what else is needed on this. Um, did you have any other like questions or concerns?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, that's it. Just, just, uh, those two days, that's it.
[AGENT][POSITIVE] Those 2 days. OK. All right. I appreciate you and uh somebody will be calling you back, [PII], OK?
[CUSTOMER][NEUTRAL] Mhm. OK.
[CUSTOMER][POSITIVE] OK, alright, thank you.
[AGENT][POSITIVE] You're welcome. Bye-bye.
[CUSTOMER][NEUTRAL] Uh huh bye bye.