AccountId: 011433970860
ContactId: 1b3f668d-326c-4872-8f3f-c66655b901a6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 750140 ms
Total Talk Time (AGENT): 267970 ms
Total Talk Time (CUSTOMER): 264496 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/1b3f668d-326c-4872-8f3f-c66655b901a6_20250624T15:55_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII], and I have a couple of questions about some claims.
[AGENT][POSITIVE] OK. Happy to help with some claims. Do we have a policy number?
[CUSTOMER][NEUTRAL] Uh, yes, just a moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have claim numbers. Will that help or you need the policy number first?
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] We can do claim numbers that works instead, no worries.
[CUSTOMER][NEUTRAL] OK, let me see where I'm at.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Because the ones I'm looking at are pending saying you need information, let's try this the letter C.
[CUSTOMER][NEUTRAL] And I think it's 0083591.
[AGENT][NEUTRAL] OK, that's like the service center confirmation number, not the actual claim number.
[CUSTOMER][NEUTRAL] OK, uh, I'm gonna go back to my dashboard here and it just takes a while for everything to load up.
[AGENT][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Probably ID card.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Group number is GCP 24.
[AGENT][NEUTRAL] Do you see a certificate number, anything like that?
[CUSTOMER][NEUTRAL] Um, no, it just that gives that number. It says group cancer insurance, cancer and specified oh policy number. I'm sorry.
[AGENT][NEUTRAL] Uh-huh. That's OK.
[CUSTOMER][NEUTRAL] Alright, 255.
[CUSTOMER][NEUTRAL] 8279
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] I'm a little slow.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] No, don't worry about it, [PII], it's totally fine. Um let me just verify your date of birth, please, and then address.
[CUSTOMER][NEUTRAL] OK, it's [PII].
[AGENT][NEUTRAL] OK. All right.
[AGENT][NEUTRAL] So the last claim I see on here was submitted on the [PII].
[AGENT][NEUTRAL] It looks like it is still in progress. Nothing has been decided on it as of right now.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, is it because it needs some more information?
[AGENT][NEGATIVE] It's not asking for anything additional. It looks like it just hasn't been worked yet.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then I'll go.
[AGENT][NEUTRAL] So
[CUSTOMER][NEUTRAL] Sorry, go ahead.
[AGENT][NEUTRAL] Yeah, yeah, I, oh no, I was just gonna say I don't see that as of right now you need to submit anything extra or anything like that.
[CUSTOMER][NEUTRAL] OK. Um.
[CUSTOMER][NEUTRAL] 2 more questions.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I've got a letter here.
[CUSTOMER][NEUTRAL] That says I need to give.
[CUSTOMER][NEUTRAL] The EOB.
[CUSTOMER][NEUTRAL] Can I give you that claim number and see if we can figure this one out?
[AGENT][NEUTRAL] Yeah, what's the claim number?
[CUSTOMER][NEUTRAL] OK, 360.
[CUSTOMER][NEUTRAL] 8442
[AGENT][NEUTRAL] OK, let me pull that up.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So let's see.
[CUSTOMER][NEUTRAL] Uh, it says you paid 450 on it, but then it also says it needs the chemo radiation EOB.
[AGENT][NEUTRAL] Yeah, so date of service [PII] was for looks like uh chemo.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And that date of service is asking for the EOB from your primary for [PII].
[CUSTOMER][NEUTRAL] OK, I will go search that down.
[CUSTOMER][NEUTRAL] Let me see what file I put that one in.
[AGENT][NEUTRAL] And then,
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] I know there's a letter in my mailbox today.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh, I don't know what it's asking for yet because I haven't been there.
[AGENT][NEGATIVE] So there was a denial.
[CUSTOMER][NEUTRAL] It it shows me I got a letter.
[AGENT][NEUTRAL] OK. There was a denial for the lab test. It looks like that's not covered. So that's not asking for anything extra.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Um, and then
[AGENT][NEUTRAL] It looks like, did you also submit transportation for the [PII] maybe?
[CUSTOMER][NEUTRAL] No, I haven't done anything with transportation.
[AGENT][NEUTRAL] OK, I wonder, let's see.
[AGENT][NEUTRAL] So then it looks like then [PII], there was, it says radiation delivery.
[AGENT][NEUTRAL] Um, the radiation therapy, chemotherapy procedures related.
[CUSTOMER][NEUTRAL] OK, 316 25 OK.
[AGENT][NEGATIVE] So I'm not sure if this was the administration, the way the radiation was administered, it wasn't covered. It's looking like, yeah, it's stating that it was denied for 316.
[CUSTOMER][NEUTRAL] Yeah, um
[CUSTOMER][NEUTRAL] I haven't, that was weird to me too. I haven't had any radiation.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] So let me go look at 3:16 on my calendar.
[AGENT][POSITIVE] Amazing.
[AGENT][NEUTRAL] Let's see 316.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] And that's 4,163,160.
[AGENT][NEUTRAL] Yeah, it's straight. There's not even a procedure code, so.
[CUSTOMER][NEUTRAL] Yeah, and [PII] is a Sunday, so.
[AGENT][NEUTRAL] Hm, maybe it was an error or something, I wonder.
[CUSTOMER][NEUTRAL] Maybe.
[CUSTOMER][NEUTRAL] Hm, I know I the the week before that I had my port installed.
[AGENT][NEUTRAL] Um, I'm wondering if it's maybe that, if it was the port that it just doesn't cover.
[AGENT][NEUTRAL] Um, let me.
[CUSTOMER][NEUTRAL] Or the, even the biopsy was the week before.
[CUSTOMER][POSITIVE] But I submitted all of that and it was all accepted.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So yeah, I mean just that one date I show is needing the EOB which is at [PII] um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, and just one more question and then I will let you go on with your day.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] The one that says it paid.
[CUSTOMER][NEUTRAL] It says
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I am on or at least I put in for the direct deposit is there a specific date that that comes through?
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] Do we have a date this is a claim that was already paid for that amount?
[CUSTOMER][NEGATIVE] Well, it says it's paid but I haven't received it.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Um, and the date it says.
[CUSTOMER][NEUTRAL] You would you like the uh confirmation number?
[AGENT][NEUTRAL] Does it have a claim number or just the confirmation?
[CUSTOMER][NEUTRAL] Just the confirmation number.
[AGENT][NEUTRAL] What is that?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] OSC
[CUSTOMER][NEUTRAL] The number 85534.
[AGENT][NEUTRAL] I wonder
[CUSTOMER][NEUTRAL] Let me see let me see the document.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Policy number reference number.
[CUSTOMER][NEUTRAL] Claim number
[CUSTOMER][NEUTRAL] Would that one be better?
[AGENT][NEUTRAL] Yeah, what's that?
[CUSTOMER][NEUTRAL] OK, 350.
[CUSTOMER][NEUTRAL] 9642
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] There is so much stuff to wade through to find the correct papers.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I don't know how you guys do it.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, so let me see.
[AGENT][NEUTRAL] OK, so that was done under this other.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So,
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So that claim is back from
[AGENT][NEUTRAL] Because it was processed under your other policy number. So that claim was submitted back in [PII] in September.
[AGENT][NEUTRAL] And then it was processed and paid in September. It was actually a check sent to you, so.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK, well, I may have gotten that one.
[CUSTOMER][NEUTRAL] I have just put so much stuff. I'm telling you this is not easy to wade through.
[AGENT][NEUTRAL] Yeah, I know it's a lot.
[CUSTOMER][NEUTRAL] OK, so it was done in [PII] you said?
[AGENT][NEUTRAL] Mhm. It was processed on yeah, [PII], um, and the check was sent out for 216523.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, June.
[CUSTOMER][NEUTRAL] No, it's not going back that far. OK, well, I just.
[CUSTOMER][NEUTRAL] I'm just wondering why it came through.
[CUSTOMER][NEGATIVE] As one of my recent documents that's just threw me for a loop.
[AGENT][NEUTRAL] Hm, yeah, that's strange because.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEGATIVE] It, yeah, it's not even on the active policy number like that policy number is not active any longer.
[AGENT][NEUTRAL] You have a, you have that different one now, so.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, well, it sounds to me like I need to upload that one from 326 and then the last 3 chemos that I've had.
[AGENT][NEUTRAL] Yeah, so that's all I was asking for on that date. Yes, ma'am. Mhm.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] All right. Well, that sounds good. I appreciate your help for all of this.
[AGENT][POSITIVE] You're welcome. Anything else I can do for you?
[CUSTOMER][NEUTRAL] Uh, not for today. I'm doing all right. I appreciate it.
[AGENT][POSITIVE] All right, [PII]. Take care.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][NEUTRAL] Goodbye