AccountId: 011433970860
ContactId: 04cb9a30-f070-43b4-9d3f-105792cf6aae
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 233309 ms
Total Talk Time (AGENT): 135680 ms
Total Talk Time (CUSTOMER): 99706 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/04cb9a30-f070-43b4-9d3f-105792cf6aae_20250117T16:33_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII] with whom am I speaking and how may I help you?
[CUSTOMER][NEUTRAL] Uh, my name is [PII], and I had called earlier, um, regarding a claim, and they had told me that, uh, they put me through to one of the, uh, higher claim managers or whatever it was. Um, and they told me that they were, uh, trying to get medical records from, uh, [PII].
[CUSTOMER][NEUTRAL] And I just needed to let y'all know that my doctor is sending those today. And I was wondering if there was any, any way to expedite those or anything.
[AGENT][NEUTRAL] OK, what's your policy number, Ms. [PII]?
[CUSTOMER][NEUTRAL] Sure, it is 02549206.
[AGENT][NEUTRAL] OK, thank you for that information and please allow me one moment to get that pulled up and then I'll be able to assist you to see, uh, you know, uh, well I'll be able to answer that question for you as to whether or not we can expedite, uh, the matter. One moment mhm.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Verify your date of birth followed by your uh physical mailing address.
[CUSTOMER][NEUTRAL] OK. My date of birth is [PII].
[CUSTOMER][NEUTRAL] And my address is [PII], and that's in [PII].
[AGENT][NEUTRAL] Thank you and verify your email address.
[CUSTOMER][NEUTRAL] Sure. It's uh [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. OK, and let's see here. So, uh, what has to happen, Ms. [PII], is we have to receive those medical records first. Once they receive those medical records, they have to be sent for review to the medical review board, OK? So once they get those medical records processed, it can take up to 15 business days, but it's probably more than likely not gonna take that long, but we haven't gotten them yet.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Gee.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So that's just, that's, that's the protocol for anything. Anytime we need additional information, we request anything, the clock starts over and it starts from 15 days from that date that we received that information. But it may not take that long. I'm gonna advise you to check back tomorrow to see if the doctor has sent those, that, that information and, and ask can that be forwarded? Can someone inform the individual that's handling uh.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Uh, this claim for them an email to let them know that the medical records have been received, OK? And again, once it goes to the medical review, once it goes to medical review, we don't have a time frame on that. That's a totally different set of, uh, that's a board. So it's when they review it and they return it. Yes, ma'am. So at this point, that's all you can do is I would check back tomorrow to see if the doctor had sent what was needed.
[CUSTOMER][NEUTRAL] Oh, OK. OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And have someone reach out to the uh examiner that's processing your claim to let he or she know that the medical records have been sent. At this point, we don't have anything, OK?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. OK. OK.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] All right. Anything else I can help you with? You're welcome.
[CUSTOMER][POSITIVE] I do appreciate it.
[CUSTOMER][POSITIVE] I think that was it. I do appreciate your help. All right, thank you. Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You're welcome. Alright, thank you for calling ATL, Miss [PII]. Take care. Bye bye.
[CUSTOMER][NEUTRAL] You too. Bye-bye.