AccountId: 011433970860
ContactId: 3dc6d655-880f-466b-8acf-9b2c33e4732d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 741919 ms
Total Talk Time (AGENT): 244910 ms
Total Talk Time (CUSTOMER): 362603 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/30/3dc6d655-880f-466b-8acf-9b2c33e4732d_20250530T19:56_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, I'm not sure if I hit the correct extension, but I'm trying to file a claim for um.
[CUSTOMER][NEUTRAL] A mammogram, would that be a wellness claim?
[AGENT][NEUTRAL] Yes ma'am, and I can help you with your claim. Can I please get your name and your callback number?
[CUSTOMER][NEUTRAL] Uh, name is [PII]. Last name is [PII]. It's actually spelled [PII]
[CUSTOMER][NEUTRAL] And my call back number would be [PII].
[AGENT][NEUTRAL] Thank you, Ms. [PII]. And then what is your policy number, ma'am?
[CUSTOMER][NEUTRAL] Ah, see, I knew you were gonna ask me that. Um, where would I find that? Is it on if I'm logged into my account, can I get it from there anywhere?
[AGENT][NEUTRAL] Yes ma'am, it should be in the OR online service center or if you don't see it I can um get your social and pull it in that way either way.
[CUSTOMER][NEUTRAL] I don't say, OK, [PII], um, my social, I'm sorry, um.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, let me look you up real quick, Miss [PII].
[AGENT][NEUTRAL] OK, I believe I have, I have you. Can you please give me your date of birth?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and then what is your address, phone number and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] If, um, wait, tell me that again. My address is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] And your email address?
[CUSTOMER][NEUTRAL] Um, uh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then the phone number that you gave me to call you back on, is that your cell phone number?
[CUSTOMER][NEUTRAL] It is.
[AGENT][NEUTRAL] OK, thank you so much, Ms. [PII]. All right, so if you're in the online service center, if you've signed up for that, when you go to claims and forms, you're gonna choose the wellness claim form.
[CUSTOMER][NEUTRAL] OK, because I see a little green button right here that just says file a wellness claim, is that it?
[AGENT][NEUTRAL] Yes, ma'am. Go ahead and click that button.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is it pulling up for you now?
[CUSTOMER][NEUTRAL] Uh, it's loading, loading.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] It says file a wellness claim at once, it says let's get started, who you filing a claim for and I put sell.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Then it says, can you? OK, what date was it was performed was today, which is [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] What was the name? What did I say was the name of the place? [PII]'s Breast Care Center. Let me get the right name for it. Let me see. Hold on.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] To
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] A center.
[CUSTOMER][NEUTRAL] And the phone number is [PII].
[CUSTOMER][NEUTRAL] 897.
[CUSTOMER][NEUTRAL] [PII] oops. Why did I do that [PII].
[CUSTOMER][NEUTRAL] 897.
[CUSTOMER][NEUTRAL] [PII] 0 it put the one automatically. OK, so then it wants me to select what it was formed for.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mammogram.
[CUSTOMER][NEUTRAL] Uh, OK, continue.
[CUSTOMER][NEUTRAL] Enroll in direct deposit.
[CUSTOMER][NEUTRAL] I think I have that done already.
[AGENT][NEUTRAL] You might wanna double check it just because we're um we're updating our online service center to make it more user friendly so just check that and make sure it's still filled out for you.
[CUSTOMER][NEUTRAL] OK, confirm your details and.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, so if I close this I can just, OK, let me.
[CUSTOMER][NEUTRAL] Let's see, per payment preferences I guess.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] The bank name ING, which I didn't type in the bank bank name, it automatically came up when I put in my routing information, so I guess even though.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's Capital One on my, my side, maybe Capital One is known as something else.
[AGENT][NEUTRAL] Right, um, and so when you put in that routing number, sometimes banks have more than one name. Um, if it's, if there's a corporate office or other offices under their umbrella, once you put in that ref that um routing number, it'll, it'll pull it up for you automatically.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so then that is uh correct so now I have to go back to the.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] How do I get back to the clean oh here it is. No.
[CUSTOMER][NEUTRAL] Maybe if it's on a screen. Nope.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] It timed me out or something, hold on.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEGATIVE] I lost the screen.
[AGENT][NEUTRAL] 00 darn OK sorry about that. I wanted you just make sure it was still there since we were doing updates.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Alright, so let me select self again.
[CUSTOMER][NEUTRAL] And then today's date, well.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] For.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] A sensor.
[CUSTOMER][NEUTRAL] Uh 5048 what?
[CUSTOMER][NEUTRAL] 897 86. You couldn't wait until I got done, huh?
[CUSTOMER][NEUTRAL] And select, let's see, Namo.
[CUSTOMER][NEUTRAL] Where is it? OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Continue. Alright, so direct deposit information.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] It's done. I acknowledge.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] They
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Oh, I gotta a please sign using your mouse. OK, here we go, wait, I got a sign in here.
[CUSTOMER][NEUTRAL] Signature things funny. OK, save file my claim. Now I do have a question for you. I'm not sure if you can answer that. I have like the wellness, the hospital that are critical, and I think I also.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It might have been 2 weeks ago. I totally forgot about it, but my daughter has gone to an urgent care for an injured ankle. Is that like a separate, is that through accident care or something like that?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] And that would be.
[CUSTOMER][NEUTRAL] Like can I claim that too or?
[AGENT][NEUTRAL] Yes, you can claim that too on your hospital indemnity plan.
[CUSTOMER][NEUTRAL] The hospital indemnity plan. OK.
[AGENT][NEUTRAL] Yes ma'am, um, and this is just to verify your benefits. It's not a guarantee of payment, but you have outpatient accident and sickness treatment for urgent care center. You get two of them per calendar year that pays $100.
[CUSTOMER][NEUTRAL] OK, so, so.
[CUSTOMER][NEUTRAL] OK, and then, so, but my mammogram claim is separate from if I claim her accident, correct? So I'll get, I would get paid on both of them.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, ma'am. That would be.
[AGENT][NEUTRAL] Yes, file on, um, on both of them. It would be separate.
[CUSTOMER][NEUTRAL] OK, so then to go do hers I would right here it says the other spot they have just the wellness clean, but the other one it says upload.
[CUSTOMER][NEUTRAL] No, that's to upload documents. Where do I file?
[CUSTOMER][NEUTRAL] A hos you know um what you said a hospital indemnity claim, where do I go to do that?
[AGENT][NEUTRAL] You'll go back to where all your um policies are and click on the hospital indemnity policy and it should give you an option for claims and forms on that policy.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Let's see, hold on.
[CUSTOMER][NEUTRAL] It's got group hospital indemnity and it says policy number. Do I click the policy number?
[AGENT][NEUTRAL] Yeah, go ahead and put in the policy number I can give that to you.
[AGENT][NEUTRAL] It's 2.
[CUSTOMER][NEUTRAL] No, it had where I just clicked the policy number.
[AGENT][POSITIVE] Oh, good, good.
[CUSTOMER][NEUTRAL] So let me see if it's OK.
[CUSTOMER][NEUTRAL] Let's see, policy open file. Oh, now that's just giving me the policy number. I don't see where I go and actually claim a.
[CUSTOMER][NEUTRAL] File a claim.
[AGENT][NEUTRAL] It should say claims and forms.
[CUSTOMER][NEUTRAL] Where did you say to go again?
[AGENT][NEUTRAL] It should say claims and forms.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Let's see, there's a thing up here it says claim form.
[AGENT][NEUTRAL] Yes, ma'am. And you'll choose the hospital in [PII].
[CUSTOMER][POSITIVE] Thank, OK, that's.
[CUSTOMER][NEUTRAL] Even if she just went to an urgent care and we didn't go to an ER, does that count?
[AGENT][NEUTRAL] Yes ma'am, because you have urgent care coverage on your hospital indemnity plan.
[CUSTOMER][NEUTRAL] Oh, OK, so wait, there's an accident one critical dental, direct deposit, electronic funds.
[CUSTOMER][POSITIVE] So it must be the top one.
[CUSTOMER][NEUTRAL] The one that says accident claim form.
[AGENT][NEUTRAL] Uh, no, ma'am. Um.
[CUSTOMER][NEUTRAL] Well, I don't see hospital.
[AGENT][NEUTRAL] The hospital indemnity I think is gonna be on a different.
[CUSTOMER][NEUTRAL] Oh wait, is this an alphabetical order? It is.
[AGENT][NEUTRAL] Yes, you're gonna be on like I think it's on like page 2.
[CUSTOMER][NEUTRAL] Uh, let's say.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, hospital indemnity claim form, right?
[AGENT][POSITIVE] Yes, that's one you're gonna choose.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] Alright, it's making me download the whole.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Right, you don't have to download the form, fill it out, um, send an itemized bill with the diagnosis code.
[AGENT][NEUTRAL] And procedure codes and then upload it into the claims uh into the online service center.
[CUSTOMER][NEUTRAL] Oh I don't how do I get the procedure codes?
[AGENT][NEUTRAL] You'll get that from the facility from the urgent care facility that you went to.
[AGENT][NEUTRAL] If they didn't file the claim for you.
[AGENT][NEUTRAL] You might wanna check and see if they filed the claim for you.
[CUSTOMER][NEUTRAL] Um, I know they didn't file the claim for me, but I don't see anything that has.
[CUSTOMER][NEUTRAL] Looking for all that information.
[CUSTOMER][NEGATIVE] I'm confused.
[CUSTOMER][NEUTRAL] For claims using online so.
[AGENT][NEUTRAL] The very
[AGENT][NEUTRAL] The very top page of the hospital indemnity claim form tells you everything that you need to send in. So if you reach out to the urgent care center and ask them to email you the itemized statement.
[CUSTOMER][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That's and then that will already be in your computer for you so you could just upload it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[CUSTOMER][POSITIVE] Itemized bill with diagnosis. OK, perfect, thank you so much.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] You're welcome. You're very welcome.
[CUSTOMER][POSITIVE] Appreciate it.
[AGENT][POSITIVE] No problem at all. You have a wonderful weekend. Is that everything I can help with?
[CUSTOMER][POSITIVE] Have a great day.
[CUSTOMER][POSITIVE] Thank you bye bye.
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] It is.
[AGENT][POSITIVE] Oh OK, well you take care and thanks for calling APL bye bye ma'am.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][POSITIVE] You're welcome. Bye-bye, Ms.