AccountId: 011433970860
ContactId: 37e13168-41e5-4450-b4cf-4805769f4f32
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 326160 ms
Total Talk Time (AGENT): 103781 ms
Total Talk Time (CUSTOMER): 128423 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/37e13168-41e5-4450-b4cf-4805769f4f32_20250428T14:51_UTC.wav
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[AGENT][NEUTRAL] Good Morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hey, I, um, I submitted a claim last week, um, and I went to go look at it and it looks like it wasn't paid on and I'm just trying to find out why.
[AGENT][POSITIVE] OK, sure, I can assist you with claim status. May I have your name and a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII] is my name, and the callback number is [PII].
[AGENT][NEUTRAL] Thank you and may I have the policy number, Miss?
[CUSTOMER][NEUTRAL] Yes, it is 02552172.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, for security, may I have your date of birth, mailing address, and email address on file?
[CUSTOMER][NEUTRAL] Yes, [PII] is my date of birth. Mailing address is [PII], and the email address on file is [PII].
[AGENT][NEUTRAL] OK, thank you. All right, let me look at that claim.
[CUSTOMER][NEUTRAL] And I do have there's several on there. I have the confirmation number too if that helps at all.
[AGENT][NEUTRAL] It's OK. Um, let me see, looks like they may be asking for additional information, so let me pull the documents, one moment.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm still waiting.
[CUSTOMER][NEUTRAL] OK, no, you're fine.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so it says that in order to give uh future consideration of these laws, we need supporting documentation.
[AGENT][NEUTRAL] Um, including but not limited to the itemized bill with diagnosis code, a super bill, an office note or hospital admission discharge summary.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, so I did submit my itemized bill. I, I don't know if this is the issue. I was in the hospital for 71 days straight and so my itemized bill is extremely long. Um, I'm just filing for the hospital ad admission benefit and then the daily, um.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEGATIVE] It's like daily if you're in the hospital, there's like a $50 payment per day for 5 days. I'm just filing for that, but I submitted my full itemized bill and so the itemized bill is like 5 or 6 pages long.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] OK. Um, did they have like a discharge summary indicating like how many hours and how many days he was in the hospital?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Um, I know that there is a
[CUSTOMER][NEUTRAL] Let me see, can you.
[CUSTOMER][NEUTRAL] Oh, is the only file that's on there, the claim form that y'all have on your side?
[AGENT][NEUTRAL] It looks like it's just a claim form that you submitted the last time. It looks like it's just a claim form, yes. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got you. OK, OK, OK. Would I, I'm sorry, so then I guess I didn't upload it. I'm so sorry. Um, would I just upload documents where it says my claims upload files? Would I just upload it there?
[AGENT][NEUTRAL] It's OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, yes, that's all you need to do. Just upload it as a new claim. We'll go ahead and put it all together if we need to, but yeah, just go ahead and upload it.
[CUSTOMER][POSITIVE] OK, OK, perfect. I'm so sorry. I'm sitting here. I'm like, I, I put that in there. OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It's OK.
[AGENT][POSITIVE] It's OK, no problem.
[CUSTOMER][NEUTRAL] Well then I will do that.
[AGENT][NEUTRAL] OK. So once we receive it, we'll go ahead and reprocess the claim, OK?
[CUSTOMER][POSITIVE] OK, yes ma'am. Thank you so much.
[AGENT][POSITIVE] You're welcome. Is there anything else I may help you with today?
[CUSTOMER][NEUTRAL] No, that was it. That's all.
[AGENT][POSITIVE] OK, well, thank you for calling ATL. Have a good day, Ms. [PII].
[CUSTOMER][POSITIVE] You as well. Thank you. Bye-bye.
[AGENT][POSITIVE] You're welcome. Bye bye.