AccountId: 011433970860
ContactId: c5fe81b2-7c98-40d5-b07a-a062f9eac59a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 712489 ms
Total Talk Time (AGENT): 354151 ms
Total Talk Time (CUSTOMER): 276624 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/25/c5fe81b2-7c98-40d5-b07a-a062f9eac59a_20250625T15:33_UTC.wav
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[AGENT][POSITIVE] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I have a question and this may be a big stretch, but I thought I would give it a shot anyways but last.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, January, I, um, or this past year I had, uh.
[CUSTOMER][NEUTRAL] My benefits through y'all for um hospital indemnity and um it was the first time I had ever I didn't even know what hospital indemity was um and I had a baby last January and whenever I worked for a school district and um they didn't I don't know there was miscommunication and I thought that it just kind of came to me I didn't know that I had to.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Um, fill everything out and I was in the middle. I had a [PII] and a newborn and I we were moving and all the things and um I, I lost my paperwork for y'all and then the district, the lady that ran the benefits, she, there was a new lady that came in.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I couldn't find my information on what company I had the hospital indemnity with or anything and I was just wondering, is there still any way that I can get that from last January or does is it too late?
[AGENT][NEUTRAL] Um, so I will say as long as the policy was active at the time of any sort of treatment, there's no timely filing limit, um, so if that's what you mean regarding like needing to file claims, is that what you mean?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yeah, OK, no, so there's no timely filing limit as long as it was active you could still submit that claim information so we can go ahead and get that pulled up just so we can verify uh those dates and such, um, what was your name? I'm sorry.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, it's [PII]
[AGENT][NEUTRAL] OK, and then, uh, [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, thank you. Do you happen to have that policy number?
[CUSTOMER][NEUTRAL] 2
[CUSTOMER][POSITIVE] Yes, I do.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, it is 02394321.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] OK, and then just gonna verify some information really quick uh [PII], can I get your date of birth please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] It is um [PII].
[AGENT][NEUTRAL] Perfect. Uh, last thing I need is the email address that we've got on file for you. Uh, looks like it is through your employer.
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, thank you so much for verifying all of that. OK, now I know you said last [PII], do you mean, uh, [PII] or [PII]?
[CUSTOMER][NEUTRAL] [PII], sorry.
[AGENT][NEUTRAL] [PII]. OK, perfect. No, no, no, you're fine just wanted to make sure uh we were on the same page with that. OK, so I've got this policy was active [PII] until [PII], so absolutely was active during that time.
[AGENT][NEUTRAL] Give me just a moment. Let me get that policy pulled up.
[CUSTOMER][NEUTRAL] And since then we've moved um like houses and so that was our my address when I had the benefits with y'all and so now it's a new mailing address. I don't know if you'll need to change that or not.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I can, let's see. Give me just a moment. Let me get those uh benefits pulled up here, see what what's uh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Would apply to this.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alrighty, so the benefits for this policy, you did have a hospital admission benefit, hospital consignment benefit.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] And then of course intensive care and rehabilitation, but I do believe the admission and confinement are gonna be the only ones that would apply um to that. So whenever you, well, and I can send you this as well if you needed a copy um for your records.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, uh, do you want me to just.
[CUSTOMER][NEUTRAL] So do I, am I?
[AGENT][NEUTRAL] I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] Sorry, go ahead.
[AGENT][NEUTRAL] No, no, no, you're fine.
[CUSTOMER][NEUTRAL] You go ahead.
[AGENT][NEUTRAL] OK, I was just gonna ask if you wanna read.
[CUSTOMER][NEUTRAL] Well, I was just wondering like do.
[AGENT][NEUTRAL] Sorry.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You go, you go.
[CUSTOMER][POSITIVE] No, you're totally fine.
[CUSTOMER][NEUTRAL] Well, I was just wondering like do I am I making the claim through you or do I need to do it on my own?
[AGENT][NEUTRAL] Um, so yes, uh, you would not be able to file with me, um, I, we have, um, a mailing address and then if you have access to a fax machine you can fax it to us as well.
[CUSTOMER][NEUTRAL] OK yeah I will I'll have to do mailing.
[AGENT][NEUTRAL] OK, I can go ahead and give you that information.
[CUSTOMER][NEUTRAL] OK, hang on just a second.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] And how do, I mean,
[CUSTOMER][NEUTRAL] This this is kind of new to me, so I'm, I don't really know like I how do I.
[AGENT][NEUTRAL] No, you're fine, yeah, as soon as you're ready to write down the address I'll go ahead and let you know exactly uh the exact information we need for claims as well.
[CUSTOMER][NEUTRAL] OK alright and what's the mailing?
[AGENT][NEUTRAL] That is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that is in [PII]y, Oklahoma.
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] Ah
[CUSTOMER][NEUTRAL] OK, so let me repeat that. It's [PII] and then [PII] [PII].
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] OK.
[AGENT][POSITIVE] Otherwise, that is correct, yes.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] OK and so the information that we need for claims of course is going to be the correct claim form filled out which I can um email that to you as well as a copy of the policy so that you can have that uh and then we would need the itemized statement.
[AGENT][NEUTRAL] That shows diagnosis and procedure codes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And so of course with um you know all providers are different um but with it being um you know obviously having a baby I would go ahead and ask them if it's not already going to be included in that information for the date and time of your admission and then date and time of your discharge.
[CUSTOMER][NEUTRAL] OK, so you said that that I needed to get an itemized statement of diagnosis and what else?
[AGENT][NEUTRAL] Procedure codes.
[CUSTOMER][NEUTRAL] OK, procedure codes and then what was the second thing you had said?
[AGENT][NEUTRAL] Um, the admission date and time as well as the discharge date and time.
[CUSTOMER][NEUTRAL] The admission.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Um, and that's going to be it, uh, generally, um, if you, you know, give them a call and explain this is what you need, uh, you know, just mention that it's for a claim that you're filing, and they should know what to give you if there's any confusion though they are more than welcome to give us a call as well but generally you know they're pretty good so.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, OK, um, and so after once I get the claim form from you and then the state the itemized statement and the mission date and discharge date, um, I mail all of those like in a file or like in an envelope to y'all or to the PO box.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then of course depending on um how long it takes to get here you know it can take a week or two depending on the post office um but once we've received that information it can take about 7 to 10 business days for that information to complete processing and so of course in the meantime you are more than welcome to give us a call to check if it's been received and then the status and such.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] So if you would
[CUSTOMER][NEUTRAL] And that that this is the
[AGENT][NEUTRAL] I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Um, so is it easier, um, what is the quicker way through fact?
[AGENT][NEUTRAL] I would say so, yes, if you have access to a fax machine, I would say so.
[CUSTOMER][NEUTRAL] I would
[CUSTOMER][NEUTRAL] OK, will you go ahead and give me the fax number as well just in case I can do that.
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] Definitely.
[AGENT][NEUTRAL] Yeah, that is uh 877.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then if you would I'm going to go ahead and update your um mailing address as well uh so if you would go ahead and give me your current address.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Sunset
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Drive, and then it's [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Could you spell that for me? I'm sorry.
[CUSTOMER][NEUTRAL] Sorry, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then [PII].
[AGENT][NEUTRAL] OK, I'm gonna go ahead and read that back. That was [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I will go ahead and get that updated as well um and so you would be receiving a paper check in the mail unless you had let me see.
[AGENT][NEUTRAL] Yeah, OK, so it would be as a paper check in the mail but uh we would send that benefit to you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, that works.
[AGENT][NEUTRAL] Alright, um, now for the claim form and then of course, of course the copy of the policy, um, did you want me to send that to the email address, uh, that we have on file for you, the one through your employer, or was there a different one you'd rather me send that to?
[CUSTOMER][NEUTRAL] Um, you can just send it through the one through my employer, that's fine.
[AGENT][POSITIVE] OK alright awesome so it will be the single email that will have the policy certificate as well as the claim form attached and of course if you have any questions with anything uh definitely give us a call back and we'll do what we can to help you out. Did you have any other questions for me at the moment?
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][POSITIVE] Awesome thank
[CUSTOMER][POSITIVE] That's it thank you so much for all your help.
[AGENT][POSITIVE] All right. You are very welcome. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] OK thanks bye bye.
[AGENT][POSITIVE] Thank you bye bye.