AccountId: 011433970860
ContactId: 7867e62f-75d8-4d03-a69a-d18d9166dca3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 419459 ms
Total Talk Time (AGENT): 200261 ms
Total Talk Time (CUSTOMER): 190049 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/7867e62f-75d8-4d03-a69a-d18d9166dca3_20250428T13:29_UTC.wav
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[AGENT][NEUTRAL] For contacting ATL, my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], good morning. How are you? My name is [PII].
[CUSTOMER][NEUTRAL] And I'm calling to follow up with my name.
[CUSTOMER][NEUTRAL] Because I believe.
[AGENT][NEUTRAL] OK, I can certainly
[CUSTOMER][NEUTRAL] OK. Uh, I, can I give you the reference number?
[AGENT][POSITIVE] Yes, do you have your policy number there with you, [PII]? I'll be glad to look at it.
[CUSTOMER][NEUTRAL] OK, my policy number is 02111201.
[AGENT][NEUTRAL] Thank you. If I could just verify your um uh your last name, date of birth, and a phone number, please, while I'm looking this up.
[CUSTOMER][NEUTRAL] [PII] share [PII] and my phone number is [PII].
[AGENT][POSITIVE] Wonderful. Thank you very much. So I've looked this up and um what date of service, what claim are are we looking at? Are you the one that you just submitted?
[CUSTOMER][NEUTRAL] Well, I have, I think it's too clean because I was in the hospital twice. I was admitted on the [PII], and I believe I was released, I don't remember the dates anymore. I think it was like
[CUSTOMER][NEUTRAL] The [PII], and then I went back to the hospital on Sunday and got released on a Saturday. So I did two claims, and I believe that you guys were waiting.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] On the bill from the hospital, but I called the hospital and they told me that they don't send me bills that I need to go online on my chart, so I did.
[CUSTOMER][NEUTRAL] And I uploaded it to you guys I think it was last week Friday.
[CUSTOMER][NEUTRAL] So I was just calling to confirm or follow up.
[AGENT][NEUTRAL] OK, yes, um, let me.
[CUSTOMER][POSITIVE] I don't know, it's my first thing having to do a game, so I'm like really.
[CUSTOMER][NEUTRAL] You want this.
[AGENT][NEUTRAL] Right, I do understand. So what we're looking for is, is the, the discharge uh the admittance date and the discharge and it's um
[AGENT][NEUTRAL] Uh, so let me just see what we have here, uh.
[CUSTOMER][NEUTRAL] It's on the paperwork that I send it.
[AGENT][NEUTRAL] OK, let me, let me see what I've got here. I'm just trying to pull it up and I apologize my computer is a little bit slow here, so.
[AGENT][NEUTRAL] Let's see what we have um.
[CUSTOMER][NEUTRAL] But if you need it, I could go through the paperwork.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Waiting for it to come up now and then we can look at it. So I know you, so you're saying that the documents that you just sent have the admittance and discharge date, so let's see.
[CUSTOMER][NEUTRAL] That's
[AGENT][NEUTRAL] So what we'll do.
[CUSTOMER][NEUTRAL] Well, the papers that I loaded first, it was, uh, you should have the, the day that I went in and discharged because it's the papers that I got from the hospital and then I send you guys the bills that are on my on my chart online through Memorial.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK. Well, what I think what they're looking for is the actual time, um, the, the time that you were admitted and discharged and, and, uh, let's see what we can find here.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I took that.
[CUSTOMER][NEGATIVE] I have to go back.
[AGENT][NEUTRAL] So they don't, they don't necessarily, the hospital won't they uh usually send their, the bill um uh to uh
[CUSTOMER][NEUTRAL] Well, it says it right here on the on the top it says after visit summary, so it looks like I got a, I mean I got admitted [PII] and was sent home on the [PII], and then I went back into the hospital [PII] and I was sent home [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh.
[AGENT][NEUTRAL] OK. OK, I see. So let me go ahead and, and uh they will go ahead and, and review this and um uh they will uh what they'll do is they'll go ahead and, and that since I, I do see that on there and so um it looks like we did get it on Friday. So what they'll do is they will add this to the existing paperwork that we have and then they'll, they will process it from there. Um, so it does look like we, we did receive it, um, and so what, uh, we're just gonna wait and, and send it to the examiner.
[CUSTOMER][NEUTRAL] We can
[AGENT][NEUTRAL] And have them uh reprocess it.
[AGENT][NEUTRAL] Now is there, uh, is there
[CUSTOMER][NEGATIVE] Because what what you guys received was the bill, like what I saw on my chart. But the when I did the claim, you guys had the day that I went in the hospital and was sent home and everything.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Well, let me send this to them and see if this will, this will work. Now, is this the only, uh, this is the only claim that we're looking at? Is it, is this the only one that, uh, that we needed to? All right, yes, together, yes, I do see where there are two, where we have um
[CUSTOMER][NEUTRAL] There's 2 claims.
[AGENT][NEUTRAL] Uh, [PII] and the [PII].
[CUSTOMER][NEUTRAL] I mean, I, I
[CUSTOMER][NEUTRAL] Yeah, because I mean I'm still going because I have an open wound, so I'm going to the hospital but it's like an outpatient thing.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] So I don't get, I'm not staying in the hospital. That's what you see the 3:402 times that, every time I go to the wound doctor, it's an outpatient visit. But I still loaded it because I don't know if I still need it, you know what I mean? I don't know.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] I put everything that I had on my chart as a bill to Memorial.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Because I opened it a while back already and I haven't got an answer and I.
[CUSTOMER][NEGATIVE] Obviously I'm not working, so I'm not getting paid, so and the bills are coming.
[AGENT][NEUTRAL] Well, let me go ahead and send this, uh, we do have it and so the, the examiner will be able to look at this and uh then we can see whether, uh, you know, what, uh what we can do.
[AGENT][NEUTRAL] So that we do have it and then uh as soon as they, you know, what we do is it usually takes um 8 to 10 business days to be processed, but uh now that we have it, um we can go or now that we have these documents, they can, they can review them and um and see if that that would be adequate to to pay the bill that to to finish the claim off.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] OK, do I expect a call back from anybody or just, I just have to wait 6 to 8 days now?
[AGENT][NEUTRAL] No, what, yes, yes, what they do is they will send you an explanation of benefits.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] And uh also if you've got, since you've gone online, you can also go online to see when it's processed.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK, and usually the money just gets deposited to my account?
[AGENT][POSITIVE] Uh, yes, that's correct. Yeah, let's see, I think you've got, um, let me just check here because I do believe you've got.
[AGENT][NEUTRAL] Uh yes, you filled out a direct deposit slip, so yes, that's what that's for.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So, um, yeah, they'll just have to review the documents and see if, uh, uh.
[AGENT][NEUTRAL] And you will be able to see that on the on the explanation of benefits and you'll be able to to track that online when it's processed.
[CUSTOMER][POSITIVE] Alright, thank you so much. Sorry to bother you. I just wanted to follow up.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No, no, that's what we're here for.
[AGENT][POSITIVE] Certainly, well thank you for contacting ATL. You have a very good
[CUSTOMER][POSITIVE] All right, thank you so