AccountId: 011433970860
ContactId: 50e6d3cd-57e7-40c5-b948-8ff3151d8035
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 531130 ms
Total Talk Time (AGENT): 153380 ms
Total Talk Time (CUSTOMER): 143849 ms
Interruptions: 2
Overall Sentiment: AGENT=0.6, CUSTOMER=-0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/09/50e6d3cd-57e7-40c5-b948-8ff3151d8035_20250409T19:44_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, I'm going to just uh see if you can give me your fax number for uh claim filing.
[AGENT][POSITIVE] Yes ma'am, I can give
[CUSTOMER][NEUTRAL] To my cancer policy.
[AGENT][NEUTRAL] Yes, absolutely. The fax number is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Awesome. OK.
[CUSTOMER][NEUTRAL] Alright, can you also give me a status on a claim submission?
[AGENT][NEUTRAL] I can. Can I please get your name and your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Absolutely, uh, it's [PII] and my policy number is 00447859.
[AGENT][NEUTRAL] OK, and then Miss [PII], what is your callback number?
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, let me look that up real quick.
[AGENT][NEUTRAL] Give me just a second.
[CUSTOMER][NEUTRAL] I did get a confirmation on the submission, but I just wanted to see where we are.
[AGENT][NEUTRAL] Right
[AGENT][NEUTRAL] I can let you know.
[AGENT][NEUTRAL] It's gonna be just a moment while I pull it up for you.
[AGENT][NEUTRAL] OK, Miss [PII], I'll need for you to verify your policy. Can you please give me your date of birth?
[CUSTOMER][NEUTRAL] Sure, uh, [PII].
[AGENT][NEUTRAL] Thank you. And then I'll also need your address, phone number, and email address that we have on the policy for you.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the email address I don't think I have one on file.
[AGENT][NEUTRAL] No, ma'am, you don't. And then um.
[CUSTOMER][NEUTRAL] Um.
[AGENT][NEUTRAL] The phone number that you gave me to call you back on if we're disconnected, is that your cell phone?
[CUSTOMER][NEUTRAL] It is.
[AGENT][NEUTRAL] OK, thank you, Ms. [PII]. And is the claim for yourself?
[CUSTOMER][NEUTRAL] Uh, the one that I submitted on [PII] would have been out of my husband [PII].
[AGENT][NEUTRAL] Let me look.
[AGENT][NEUTRAL] OK, so it's asking um for to please provide copies of your explanation of update.
[CUSTOMER][NEUTRAL] What does that mean?
[AGENT][NEUTRAL] The, the explanation of benefits is what I'm thinking that the code that it's given for hold, um, pending information is for uh explanation of benefits from the primary insurance carrier.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] They already have that.
[AGENT][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Now I can have somebody call you back from the claims department and further explain it to you if you would like for me to do that for you.
[CUSTOMER][NEUTRAL] I try to uh.
[CUSTOMER][NEUTRAL] Uh, let me ask you something. When, um, what's the date of on their response?
[AGENT][NEUTRAL] Uh, [PII] of.
[CUSTOMER][NEUTRAL] I, I submitted this [PII], OK, so this is just, it's on it, it's on its way.
[AGENT][NEUTRAL] Oh, this is, yeah.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Alright, it looks like it's gonna keep going back and forth.
[AGENT][NEUTRAL] Right, once they receive it.
[CUSTOMER][NEUTRAL] And I give them a claim number.
[CUSTOMER][NEUTRAL] But I gave them the I.
[AGENT][NEUTRAL] Once they receive it, they will reprocess.
[CUSTOMER][NEGATIVE] Yeah, that's a problem though is that they already have it on a prior claim, and that's why I identified the claim number so that they would go back and look back and look at what they already have. They're just to keep going back and forth. So at this point what I let me get all my paperwork together and this time I'm going to the care team because now I've lost total confidence in this adjuster.
[AGENT][NEUTRAL] Oh.
[AGENT][POSITIVE] Oh, I'm very sorry, ma'am. Um.
[CUSTOMER][NEGATIVE] This, this is something, there's something not right about this.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] If if you would like, like I said, we can get you further help and have somebody from the uh claims examiner call you.
[CUSTOMER][NEUTRAL] Alright, again let me.
[AGENT][NEUTRAL] And talk you through what needs to be said.
[CUSTOMER][NEUTRAL] Let me, uh.
[CUSTOMER][NEUTRAL] Yeah, let me do that uh let me uh get all my paperwork together that way I have something I've got to almost be armed when I talk to them.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, all right.
[CUSTOMER][NEUTRAL] That way, otherwise we'll just keep otherwise we just keep going back and forth.
[AGENT][NEUTRAL] Yes, I understand. OK, well, I'm gonna, um, I'm gonna need to put you on a brief hold while I get that, um, request in, and I will be right back, miss, um.
[CUSTOMER][POSITIVE] OK, thank you very much.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] I'll be right back with you as soon as I get that paperwork done, OK? It'll be a brief hold.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding for me, Miss [PII]. I do have that request in now for you to receive a call back. You should be getting a call back within 24 hours from somebody in the claims department.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] OK, I appreciate it thank you.
[AGENT][POSITIVE] OK, you're very welcome. I hope you have a wonderful day. Is there anything else, Miss [PII], I can help you with before we go?
[CUSTOMER][NEUTRAL] Very
[CUSTOMER][POSITIVE] No, no, that would be fine, thank you.
[CUSTOMER][NEUTRAL] All right bye bye.