AccountId: 011433970860
ContactId: 6374418c-deeb-4ec3-8ae7-9d2b66c4acfd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 477130 ms
Total Talk Time (AGENT): 115358 ms
Total Talk Time (CUSTOMER): 127908 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=-0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/6374418c-deeb-4ec3-8ae7-9d2b66c4acfd_20250327T15:07_UTC.wav
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[CUSTOMER][NEUTRAL] Be scheduling I guess.
[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I have a couple of questions. Um, I received an EOB back stating that you will not pay for a stool sample that is now coded as a colonoscopy, yada yada from what my primary said and what the doctor's office said.
[CUSTOMER][NEUTRAL] Because it was done at home. Um, I don't know if the doctor writes a summary because this was something that needed to be looked at ASAP, I was told, so that's why it was handled this way instead of having the colonoscopy done in the hospital because they didn't want me to wait for that amount of time, if that makes sense.
[CUSTOMER][NEUTRAL] Are you there [PII]?
[AGENT][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] [PII], yes ma'am.
[AGENT][NEUTRAL] Yes ma'am, I can hear you. Yes, can I please have your name and your policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] My name is [PII] Policy number is 02440284. I also have a claim number and date of service.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's verify your policy real quick and then I'll get that claim number from you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, Ms. [PII], 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 an email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] [PII] email [PII].
[AGENT][NEUTRAL] And then one last verification, can you give me your cell phone number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK thank you and if our call is disconnected Ms. [PII], can I call you back at that number?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][POSITIVE] OK, thank you. I appreciate that. All right, and what is the claim number, please?
[CUSTOMER][NEUTRAL] Claim number is 3,557,450.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[AGENT][NEUTRAL] Right, I do see where they sent you something saying it wasn't covered in a place of service as outlined in the policy contract.
[AGENT][NEUTRAL] So what I'm going
[CUSTOMER][NEUTRAL] Right, it was done at home. It's an at home it's an at home procedure, um, that my insurance wanted done prior to having an emergency colonoscopy if that makes sense because it was like 4 months down the road until they could get me in, yeah.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It does.
[AGENT][NEUTRAL] I understand. So what I'm going to do is I'm going to request that a claims examiner call you back so that you can let them know the information that you let me know and see if there's anything they could do or not, OK? So we're going.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] That would be fantastic.
[AGENT][NEUTRAL] Yes ma'am. I wanna make sure that you get somebody that actually reviews the claims, so I'm gonna put you on a quick hold um while I get that request drawn up and I will be right back, Ms. [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm. Mhm.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're very welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] A dog.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] 333 42.
[AGENT][NEUTRAL] OK, Ms. [PII], I've got that request in and you should be receiving a phone call within 24 hours.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, 24 hours and what are your hours of operation?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] I was just going to tell you that we're open until [PII] this evening and then we'll reopen again at [PII] in the morning.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And is that Central time?
[AGENT][NEUTRAL] Yes ma'am, and I gave him your um cell phone number to call you back on.
[CUSTOMER][NEUTRAL] OK dokey.
[CUSTOMER][NEUTRAL] OK, and what is your name, dear?
[AGENT][NEUTRAL] My name is [PII]
[CUSTOMER][NEUTRAL] OK, I
[CUSTOMER][POSITIVE] I thank you so much [PII].
[AGENT][POSITIVE] You're very welcome. I hope you have a wonderful night and thank you so much for calling APL.
[CUSTOMER][POSITIVE] You too thanks bye bye.
[AGENT][NEUTRAL] Bye-bye.