AccountId: 011433970860
ContactId: 8291cdbe-376f-4e8e-bd38-7d7fd958f933
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 189919 ms
Total Talk Time (AGENT): 129538 ms
Total Talk Time (CUSTOMER): 65536 ms
Interruptions: 1
Overall Sentiment: AGENT=2.7, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/8291cdbe-376f-4e8e-bd38-7d7fd958f933_20250219T18:57_UTC.wav
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[AGENT][NEUTRAL] For contacting APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, yes, my name is [PII], and I'm calling because you sent my husband an explanation of benefits and it says that you need more information, um, an explanation of benefits from our insurance.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And I don't know how to get that to you. What would you like, how would you, would you like me to email it to you guys or would you like me to fax it?
[AGENT][NEUTRAL] Uh, you can fax it or email it. [PII], if I can have this policy number, um, just so I can see the claim before I tell you what we need to do.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The claim that you want the claim number?
[AGENT][POSITIVE] Oh, that would be great.
[CUSTOMER][NEUTRAL] Oh, here's the policy number. I didn't see it. It's 02489440.
[AGENT][POSITIVE] Thank you so much. And if I could just verify uh your name, uh date of birth, and a phone number, please, ma'am, and while I'm looking at that.
[CUSTOMER][NEUTRAL] 92926-70 and his um his phone number is [PII].
[AGENT][POSITIVE] Wonderful. OK, so I'm glad, thank you so much for giving me that information. Um, so the thing with this is that um you don't have to do anything, OK? Uh, you don't have to get the EOB to us. So what has happened is that uh this um hospital has sent us a, a claim.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] Uh, which we will, you know, we have no problem paying, that's not the problem. What we're looking for is your explanation of benefits. So we have sent that on to the um to the provider and then they will send us a copy of your explanation of benefits. Now usually what has happened is that um they don't realize that we're the secondary insurance and they just, you know, they'll fax it to us, mail it to us, it doesn't really matter, but what we need to let you know.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, is that something has been filed through your, through your provider, uh, through a, through a provider and um if this is uh someone that your husband didn't go to, we need to know that. If it is somebody that your husband went to and we're just waiting to get it paid, that's fine. This is just, um, FYI for you. You, you know that somebody filed a claim. So that's all that is.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][POSITIVE] OK, yeah, because that we thought you wanted us to send it which we are saving everything because he was in the hospital so just in case we need it we have it.
[AGENT][NEUTRAL] That's a wonderful idea because if you, uh, what you can do is you can go ahead and check with us, um, again, uh, it usually takes about 7 to 8 business days for them to get back in touch with us. If, if you feel that this isn't, if it's taking too long, you can send us the EOB yourself. We still pay the provider, but, um, but that's all that is is just to let you know, you know, this is somebody who filed through your insurance. You just need to know that. Now, are there any other claims on his behalf or yours that we need to, to go over, um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, I appreciate it.
[CUSTOMER][NEUTRAL] There's a lot of, not, not yet. There's a lot of claims that are gonna be coming through um because he was in the hospital. So, as, as, as we get them, we'll, we'll call.
[AGENT][POSITIVE] Oh, I'm sorry.
[AGENT][NEUTRAL] Yes, please do. Yeah, so that's, that's what we've got now, um, and as soon as we, uh, it usually takes us 3 to 6 business days after we get those for us to get those, uh, paid. It's just that in this one particular case we had to ask them for uh that extra information, but yeah, that, that's it. Yeah, they'll take care of it. They'll send it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Thank you.
[AGENT][POSITIVE] OK, thanks for contacting ATL. Have a very good day.