AccountId: 011433970860
ContactId: 5394788b-3b52-4a20-b86b-a2ba503c8738
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 459899 ms
Total Talk Time (AGENT): 146034 ms
Total Talk Time (CUSTOMER): 235905 ms
Interruptions: 3
Overall Sentiment: AGENT=0.6, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/5394788b-3b52-4a20-b86b-a2ba503c8738_20250512T15:29_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh yes, ma'am. I just had a quick question. I have um a claim in process, um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's for my husband and I did receive an itemized bill but it looking at how this came and it looks like.
[CUSTOMER][NEUTRAL] The hospital sent you a copy and me a copy. So I just want to make sure that you do have a copy of the itemized hospital bills.
[AGENT][NEUTRAL] OK, I can check that for you. What's your name?
[CUSTOMER][NEUTRAL] Uh, it's gonna be under [PII]
[AGENT][NEUTRAL] Mhm. And I
[AGENT][NEUTRAL] And I need your name, your first name?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] My, my name is [PII] or [PII].
[CUSTOMER][NEUTRAL] And his wife.
[CUSTOMER][NEUTRAL] I have an account number here from Advent oh well that's Advent that's not for you.
[AGENT][NEUTRAL] We have to verify who we're speaking with, and I can take the policy number if you have it.
[CUSTOMER][NEUTRAL] No, it's an account number through AdventHealth to the hospital. Um, let me look here. I do have your other cell phone.
[AGENT][NEUTRAL] Like
[CUSTOMER][NEUTRAL] Uh, I have his social security number if that'll help.
[AGENT][NEUTRAL] And the
[AGENT][NEUTRAL] OK, I can search by that.
[CUSTOMER][NEUTRAL] OK. Uh [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Though there was a claim number on here, but I'm not seeing it.
[CUSTOMER][NEUTRAL] This is for the hospital indemnity.
[CUSTOMER][NEUTRAL] Yeah, yeah, out of my statement and they just sent it to me.
[CUSTOMER][NEUTRAL] OK, I don't know if this is your claim number, but I have.
[CUSTOMER][NEUTRAL] I have a
[CUSTOMER][NEUTRAL] Claim number 3594491.
[CUSTOMER][NEUTRAL] Our policy number.
[AGENT][NEUTRAL] And what policy number do you have?
[CUSTOMER][NEUTRAL] It is 021-382-22.
[AGENT][NEUTRAL] OK, that's what I show. Are you on the policy?
[CUSTOMER][NEUTRAL] Uh, no, no, um, I'm his wife. I handle his insurance and stuff because he doesn't.
[AGENT][NEUTRAL] So now in order for us to speak with you, we would need to get his permission to speak with you.
[CUSTOMER][NEUTRAL] Do you need
[CUSTOMER][NEUTRAL] Yeah,
[CUSTOMER][NEUTRAL] OK, just a moment. [PII], can you come here, please?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you come here, please?
[CUSTOMER][NEUTRAL] Identify yourself and tell them it's OK for you to talk to me for me to talk.
[AGENT][NEUTRAL] Hello, Mr. [PII]. This is [PII] with APL. Since you're the only one on the plan, we need you to give us permission to speak with your spouse, [PII], and let us know what information we can disclose to her.
[CUSTOMER][NEUTRAL] Oh, OK, yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Anything that she wants to know, she knows everything about me.
[AGENT][NEUTRAL] OK, what's her name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And your spouse's name?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. All right. Thank you, sir. Yeah, we, just for security purposes, have to get your permission.
[CUSTOMER][NEUTRAL] Thank you, yeah, she's the boss, so whatever.
[AGENT][POSITIVE] She's the boss. OK, I like that.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] I do too.
[AGENT][POSITIVE] All right. Thank you, sir.
[CUSTOMER][POSITIVE] Thank, thank you. Uh.
[AGENT][POSITIVE] All right. OK, cute.
[CUSTOMER][NEUTRAL] Yeah, we, we've already sent in a bunch of claim forms already, but there was one that they said they needed an itemized statement from the hospital.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] And yeah, I think that's what I just done.
[AGENT][NEUTRAL] What's the name of the hospital?
[CUSTOMER][NEUTRAL] It was Texas Health Hughly.
[AGENT][NEUTRAL] OK, is that the same AdventHealth Texas?
[CUSTOMER][NEGATIVE] But I think it's also no.
[CUSTOMER][NEUTRAL] And yeah, uh-huh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I see that and I see where we requested that form.
[AGENT][NEUTRAL] I mean requested the itemization.
[AGENT][NEUTRAL] And I do see some documents that were uploaded on [PII] via the online service center. Is that the itemized bill?
[CUSTOMER][NEUTRAL] Um, this was dated 4-14-4-17 [PII].
[AGENT][NEUTRAL] Yeah, so we did receive.
[AGENT][NEUTRAL] Yeah, we received the initial claim and denied it for the itemized bill, but I do see a document. It wasn't uploaded via online. It looked like it could have been mailed or faxed on [PII]. Is this the itemized bill that we, is it, is it the itemized bill?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] I haven't faxed any, no, I haven't sent anything uh for the itemized bill because I just received.
[AGENT][NEUTRAL] And it
[AGENT][NEUTRAL] OK, it could have been mailed or faxed. I'm not for sure, but we did receive something on the [PII]. Let's see, could the provider have submitted it on you all's behalf?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's very well possible they could have because I asked them to fax it directly to you and just let me know that it was sent but it looks like they sent me a copy.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][POSITIVE] I'm just doing due diligence to make sure that you do get everything you need in a timely manner.
[AGENT][NEUTRAL] So it looks like it's progress nodes.
[CUSTOMER][NEUTRAL] Yeah, see, he went.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] So this is an inpatient stay?
[AGENT][NEUTRAL] Or outpatient.
[CUSTOMER][NEUTRAL] Yes, it was supposed to be a.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It was supposed to be a day surgery outpatient day surgery, but it he had complications and it turned into almost a week long stay.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] What type of surgery did he have?
[CUSTOMER][NEUTRAL] He had a uh
[CUSTOMER][NEUTRAL] Gallbladder because he had gallstones. He had that removed and when she was in there, she saw a hernia and she repaired his hernia and when he came out, he, he.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] He had to have the intravenous IV uh for pain management.
[AGENT][NEUTRAL] Mhm. Mhm.
[CUSTOMER][NEUTRAL] And he was having his uh
[CUSTOMER][NEUTRAL] Vitals were not stabilized, so they wound up keeping him.
[AGENT][NEUTRAL] OK, so it looks like this information is progress notes. It is in line to be uh reviewed uh by the appropriate area, so.
[CUSTOMER][NEUTRAL] OK. I guess it's.
[CUSTOMER][NEUTRAL] If they need anything else from me they'll be contacting me right?
[AGENT][NEUTRAL] Right, you'll receive correspondence via mail.
[CUSTOMER][NEUTRAL] OK. All right.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alrighty, I just wanna make sure that y'all have everything you need, so I'll just hold on to this and if they need it they'll call me if they don't have it.
[AGENT][NEUTRAL] Yeah, uh, we actually correspond via mail to the address on file.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Anything else?
[CUSTOMER][POSITIVE] All right, well thank you very much. You've been very helpful. That'll be all thank you.
[AGENT][POSITIVE] Absolutely. You're welcome, [PII]. Thank you for calling APL. You too. Bye-bye.
[CUSTOMER][POSITIVE] Have a good day.
[CUSTOMER][NEUTRAL] Mhm. Bye