AccountId: 011433970860
ContactId: 11233769-222d-4cec-8fc5-c41702b01096
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 408799 ms
Total Talk Time (AGENT): 204530 ms
Total Talk Time (CUSTOMER): 201894 ms
Interruptions: 3
Overall Sentiment: AGENT=0.8, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/26/11233769-222d-4cec-8fc5-c41702b01096_20250226T14:08_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling ATL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, yes ma'am. This is [PII]. I need some assistance on how to fill out a claim form.
[AGENT][NEUTRAL] OK, sure.
[CUSTOMER][NEUTRAL] Oh, I have some questions rather.
[AGENT][NEUTRAL] OK, sure, no problem. And um may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] OK, thank you. And do you have a policy number?
[CUSTOMER][NEUTRAL] Yes, it is 2, I mean 02515176.
[AGENT][NEUTRAL] OK, thank you, Mr. [PII]. Um, let me pull this and see what product is in.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright.
[AGENT][NEUTRAL] OK, and I just need to verify your date of birth and the mailing address on file.
[CUSTOMER][NEUTRAL] OK, my date of birth is [PII].
[CUSTOMER][NEUTRAL] And what else you need?
[AGENT][NEUTRAL] The mailing address on file.
[CUSTOMER][NEUTRAL] 0 [PII].
[AGENT][NEUTRAL] All right. Thank you, Mr. [PII]. And uh do you have the claim form with you?
[CUSTOMER][NEUTRAL] Yes, I have it. I have it in front of me. It, it's a wellness, it's a wellness claim form. Now it says section A about the insured. Do I put [PII]'s name there? or do I put my name because I'm filing the claim on myself because I did a mammogram.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, um, the insured, uh, you are the insured because you're listed on the policy, so you can put your information. Mhm.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] OK. And then when it goes down to mammogram, I just put the date of service.
[AGENT][POSITIVE] Correct, yes. Mhm.
[CUSTOMER][NEUTRAL] OK. I do have a copy and then [PII] needs to sign the 2nd page page, right?
[CUSTOMER][NEUTRAL] Or do I sign it?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] You can sign the whole claim form.
[CUSTOMER][NEUTRAL] Oh, OK, so he don't have to sign since he's.
[AGENT][NEUTRAL] Mhm. No.
[CUSTOMER][NEUTRAL] The main one?
[AGENT][NEUTRAL] No, you don't have to sign. You can sign the claim form because you are listed, you are part of the policy.
[CUSTOMER][NEUTRAL] Oh, OK, well, I had got him to sign it and I was just gonna fill it out or does it matter?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] It's OK. Um, if he's already signed, it's fine. He is the owner of the policy, but you are listed as a, um, insured on the policy. So, um, yeah, it's, it's fine if he signed it or you signed it. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK. And one more, well, another question. Now, I do have my copy of my mammogram. Is that what y'all need?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, we don't need
[CUSTOMER][NEUTRAL] To show that it was taken?
[AGENT][NEUTRAL] We don't need any documentation. Um, if it's wellness, we don't need any documentation. All we need is the information of the doctors, um, of the doctor that you.
[CUSTOMER][NEUTRAL] OK, OK. Where would that, OK, where would that be, the doctors, uh, is it on the 2nd page?
[AGENT][NEUTRAL] Um, that will be in this, yeah, I believe it's the 2nd page. Let me look at the claim form really quick. Mhm mhm.
[CUSTOMER][NEUTRAL] Oh, I see, I see, I see. It says physician named who ordered the test?
[AGENT][NEUTRAL] Mhm, yes.
[CUSTOMER][NEUTRAL] Well, I didn't need a physician's name because uh my insurance picks that up yearly as long as I take my mammogram.
[CUSTOMER][NEUTRAL] Now, do I just put my primary care?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Yes, that's, that's it. Mhm. Yes, it's your primary care. Mhm.
[CUSTOMER][NEUTRAL] OK. OK, we got that. Now, I do have another claim that I'm gonna be filing, which is hospital. I was in the hospital two weeks ago. Now, I'm gonna do the same thing. I'm gonna use my name as the insured, correct?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes. Mhm.
[CUSTOMER][NEUTRAL] OK. Um, then you need, um.
[CUSTOMER][NEUTRAL] Itemized bill.
[AGENT][POSITIVE] Correct, yes. Mhm.
[CUSTOMER][NEUTRAL] OK, and do you need the discharge summary?
[CUSTOMER][NEUTRAL] When they discharged me, is that you need that also?
[AGENT][NEUTRAL] Yes, um, if he was there, um, more than 24 hours or if it was close to the 24 hours.
[AGENT][NEUTRAL] Um, because this is a hospital indemnity plan, and sometimes it does give us like, uh, you was there from just an example, uh [PII]. OK, we know that was a hospital confinement because it's a few days, but it's when the next, if it's like a next day thing, it's better to send the discharge summary so we know exactly how many hours and we can determine if it was a, a confinement, OK?
[CUSTOMER][NEUTRAL] OK, got you.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. And is that all y'all need on that one?
[AGENT][POSITIVE] Yes, that's all we need on this one.
[CUSTOMER][NEUTRAL] OK, now the thing is I don't know how to do it over the Internet, so I'm gonna be faxing this.
[AGENT][NEUTRAL] No, it's fine. It's fine. We have that option. Yes, mhm.
[CUSTOMER][NEUTRAL] So that's fine. OK, OK.
[AGENT][NEUTRAL] Yes, the fact
[CUSTOMER][NEUTRAL] OK, and there's nothing else and then what and then if if it gets approved or whatever y'all just mail a check or something?
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Correct, yes. If it's, if it's payable, we'll send you a check um by mail. If you would like to have this direct deposited to an account, then you need to send us the direct deposit form as well.
[CUSTOMER][NEUTRAL] Is that how
[CUSTOMER][NEUTRAL] OK, is that claim form on the website too?
[AGENT][NEUTRAL] Mhm, yes, yes, um, let me tell you.
[CUSTOMER][NEUTRAL] Oh, OK, so I would just add that to the paperwork?
[AGENT][POSITIVE] Yes, mhm, correct.
[CUSTOMER][NEUTRAL] OK, now if I'm adding that to the paperwork, do I have to send a voided check with that? Is that what you're saying?
[AGENT][NEUTRAL] Um, it is needed, um, but if you don't have one, you can always just fill out the information.
[CUSTOMER][NEUTRAL] Oh, OK. I didn't, you know, I don't know what it looks like because I got the forms in front of me, but I didn't know about the direct deposit.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Oh it's just one page and it's just asking you for the information. It does have a place where it says that um you're authorizing us, so you have to sign it to make it official. Mhm.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][POSITIVE] OK. Well, that sounds easier for me, so that's what I'm gonna go do.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[CUSTOMER][POSITIVE] All right, hon, I think you answered all my questions.
[AGENT][NEUTRAL] All right, Mr. [PII], is there anything else I can help you with today? Any other questions or concerns?
[CUSTOMER][NEUTRAL] Uh, nope, that's it.
[AGENT][POSITIVE] OK, well, thank you for calling ATL. You have a good day, Mr. [PII].
[CUSTOMER][POSITIVE] You too man thank you bye bye.
[AGENT][POSITIVE] Thank you. You're welcome. Bye bye.
[CUSTOMER][NEUTRAL] Uh-huh.