AccountId: 011433970860
ContactId: d4ff1d19-9bc7-42e0-b782-7cff6359da58
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 610650 ms
Total Talk Time (AGENT): 325608 ms
Total Talk Time (CUSTOMER): 196749 ms
Interruptions: 4
Overall Sentiment: AGENT=0.7, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/d4ff1d19-9bc7-42e0-b782-7cff6359da58_20250429T20:22_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] [PII], this is [PII], um.
[CUSTOMER][NEUTRAL] I wanted to find out.
[CUSTOMER][NEUTRAL] Um, I had talked to someone earlier and I had, uh, several, um.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Cancer claims to send in and somebody had told me we could just, I don't know if you scan them or, or fax them. I don't know exactly.
[CUSTOMER][NEUTRAL] Instead of mailing them.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Can you give me some information on that?
[AGENT][NEUTRAL] OK, Ms. [PII], so you're wanting to find out the different methods of submitting how you can submit a claim for review?
[CUSTOMER][NEUTRAL] Right, right.
[AGENT][POSITIVE] Yes ma'am, I can help you with that. And what is a good callback number for you please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and your policy number please?
[CUSTOMER][NEUTRAL] Oh gosh, I don't have it in front of me. I am so sorry.
[AGENT][NEUTRAL] That's OK. Um, is, are you the primary policyholder, Ms. [PII]?
[CUSTOMER][NEUTRAL] Uh, it's a
[CUSTOMER][NEUTRAL] Yes, I am.
[AGENT][NEUTRAL] OK, what is your full social and I might can look it up with with that.
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you one moment please and let me see if I can locate your information.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Oh, you're welcome.
[AGENT][NEUTRAL] OK, and Miss [PII], I'll just need to first verify some information with you for security purposes and anything, any information I do provide would be a verification of benefits and not a guarantee of payment. So first off, if you could please verify your date of birth.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you and also your home mailing address.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. The phone number that we have on file for you is the same as the one that you gave me, so that is your best contact number. Is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, thank you. And then your email address, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you so much for verifying your information. OK, Ms. [PII], so I see that I had spoken to you back on in March um and emailed you the user guide and I can see now that you have set up your profile.
[AGENT][NEUTRAL] In the portal where you had, I think you were already on the website or our portal anyway when I spoke to you, do you still have that email with that user guide?
[AGENT][NEUTRAL] That I sent to you.
[CUSTOMER][NEGATIVE] Uh, see, we're having problems, um.
[CUSTOMER][NEUTRAL] We don't have internet right now at our house, um.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] And that's where my email is, but I do have an email at school where I work. Can I give you that one?
[AGENT][NEUTRAL] OK, so what I'll need to do in order, OK, so one moment.
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] Give me just a second.
[CUSTOMER][NEGATIVE] We're, we're trying to get um internet back but we just haven't gotten it back yet.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So what I'll do then is for the time being I'm going to remove your personal email because I can only have one email on file.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] OK. So I'm gonna have to take that out. And what is your work email?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] At Lincoln prep.school.
[AGENT][NEUTRAL] Alright, Lincoln Prep.school.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, so [PII], is that correct?
[CUSTOMER][POSITIVE] Yes ma'am, yes ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so what I will do is I will email that user guide to you again to your work email address and that will give you the information uh as far as to how to go about uploading your information into your portal.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] For us to review and then whenever you know you want us to change if you if if and when you want us to put your personal email back on file we can do that you would just have to call us and for us to update it but for the time being we'll just leave your work email as what we have on record for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, alright, now did I talk to you about the uh intensive care?
[CUSTOMER][NEUTRAL] That my husband was in intensive care and the hospital coded it wrong.
[CUSTOMER][NEUTRAL] Did you suggest that I
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Now, I don't think that was me, Ms. [PII]. No, that would have been, but you and I only discussed your cancer policy to my recollection.
[CUSTOMER][NEUTRAL] Ask them to put
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Alright, if they coded it wrong what some uh someone I talked to has suggested I um.
[AGENT][NEUTRAL] What
[CUSTOMER][NEUTRAL] Maybe get his records.
[AGENT][NEUTRAL] Uh, let's see.
[CUSTOMER][NEUTRAL] I guess that's why they denied it. I think.
[AGENT][NEUTRAL] OK, so I see that I'm
[AGENT][NEUTRAL] I don't, now on that policy.
[AGENT][NEUTRAL] What was the date of service that that was for?
[CUSTOMER][NEUTRAL] It was a while back. I can't remember the exact date.
[AGENT][NEUTRAL] OK, so I just, I see where you had spoken to someone back most recently was, it looks like maybe the same day you actually talked with me, um.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] And this was about your husband and the conversation you had with the examiner and she explained to you that they needed the itemized billing showing the ICU room charges.
[CUSTOMER][NEUTRAL] OK. OK. I could not remember.
[AGENT][NEUTRAL] So to request the, yes, ma'am. It's the itemized bill showing the room charges.
[CUSTOMER][NEUTRAL] Well, I think that's what I sent in that they um.
[CUSTOMER][NEGATIVE] Had coded wrong.
[AGENT][NEUTRAL] And she said
[AGENT][NEUTRAL] Now, we can't tell, now, I don't know how to advise you on that because we can't tell them how to code anything. Um, that's illegal for us to do. So, I can see where she also mentioned medical records.
[CUSTOMER][NEUTRAL] Right, and that.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It says that she explained about getting the itemized bill showing room charge for the highest level of care.
[AGENT][NEUTRAL] Or which would be the ICU or if not available, the medical records showing the admission and discharge from the ICU.
[CUSTOMER][NEUTRAL] Medical records that what she.
[AGENT][NEUTRAL] That that would show his admit.
[CUSTOMER][NEUTRAL] The
[AGENT][NEUTRAL] Admission and discharge from the ICU.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Say yes, ma'am.
[CUSTOMER][NEUTRAL] That, that's what I was talking about.
[AGENT][NEUTRAL] Oh, OK. Yes, ma'am.
[CUSTOMER][NEUTRAL] I couldn't remember, girl, I have slept.
[AGENT][NEUTRAL] I know, I understand. You have a lot going on, but yes, ma'am, no, that wasn't, I didn't discuss that with you, but that is the note from the discussion that you all did have.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Either the itemized bill showing that he was in the ICU with the all, you know.
[CUSTOMER][NEUTRAL] OK, well.
[AGENT][NEUTRAL] That information.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Showing the room charges for the highest level of care or if that's not available, the medical records showing.
[AGENT][NEUTRAL] Admission and discharge from ICU.
[CUSTOMER][NEUTRAL] OK, I have got that now. I wrote it down this time.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] Alright well thank you so much I appreciate.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Well, you, oh, you, uh, well, it's my pleasure, Ms. [PII].
[CUSTOMER][NEUTRAL] And you have
[CUSTOMER][POSITIVE] Well, you have a great day.
[AGENT][POSITIVE] Yes, ma'am. I hope you do too. Oh, thank you so much. I hope you do too, and if we can help you in any way, just give us a call and we'll be more than happy to.
[CUSTOMER][NEUTRAL] Rest of your
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I certainly will. Thank you.
[AGENT][POSITIVE] All right, mister. You're welcome and thank you again for calling APL. Have a wonderful evening.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Bye-bye.
[AGENT][NEUTRAL] Bye bye.