AccountId: 011433970860
ContactId: dc5e30fd-bc1f-4b1a-9077-1aeea7eb37b6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 555760 ms
Total Talk Time (AGENT): 208176 ms
Total Talk Time (CUSTOMER): 261764 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/18/dc5e30fd-bc1f-4b1a-9077-1aeea7eb37b6_20250318T22:11_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes ma'am [PII], um, I've got a ICU policy with y'all.
[CUSTOMER][NEGATIVE] And I tried to file a claim and apparently y'all want everything up underneath the sun.
[CUSTOMER][NEGATIVE] Um, so, and I'm having a hard time getting what y'all are needing.
[CUSTOMER][NEUTRAL] Um, so I guess my question is.
[CUSTOMER][NEUTRAL] Can you tell me if I give you the policy number how much does my ICU pay per day?
[AGENT][NEUTRAL] Per day, yeah, we can definitely check on what the amount is on it per day, for sure. What's the policy number that you have there?
[CUSTOMER][NEUTRAL] 472-533.
[AGENT][NEUTRAL] OK, let's see here.
[AGENT][NEUTRAL] And then for security, I do need to verify please your name and date of birth.
[CUSTOMER][NEUTRAL] My name is [PII]. My date of birth is [PII].
[AGENT][POSITIVE] Thank you Mr.
[CUSTOMER][NEUTRAL] This policy is on my husband and I.
[AGENT][POSITIVE] OK. Thank you, Ms. [PII]. I appreciate that. And then if you could verify your address and email, please.
[CUSTOMER][NEUTRAL] Uh, my email is [PII].
[CUSTOMER][NEUTRAL] And I'm trying to think if we if I still use my PO box, but it should be [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Perfect. That's what we got. Thank you so much. OK, let me, um, I just need to pull your policy here and see what.
[AGENT][NEUTRAL] Is
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Because nowadays when you call a hospital they don't have record people anymore. It's all centralized and they work from home so you can only get it off of the MyChart app and I've done that but apparently.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, that wasn't enough for
[CUSTOMER][NEUTRAL] American public life what I sent them.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So I'm trying to weigh my options. I pay, you know, $76 a month for it, and I've had it since the [PII], and I haven't used it probably.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Not even over 1 or 2 times. I'm just trying to figure out if it's even may work.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] I'm wasting a lot of time trying to get them what they want when I send it to them, they just, I guess they won't.
[CUSTOMER][NEUTRAL] What all medicine he received and everything else.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEGATIVE] And you can't just print one page. You got to print the whole dagone thing which is like 100 pages.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, so it looks like for the first day of ICU, it looks like the first day of coverage, if it was for accident or sickness, um, it's going to pay.
[AGENT][NEUTRAL] Up to 650.
[AGENT][NEUTRAL] And it looks like the most it'll pay is for 30 total days.
[CUSTOMER][NEUTRAL] Is that all at one time or or over a lifetime?
[AGENT][NEUTRAL] Um, that would just be per confinement. So, like, um, yeah, like if you had a, for instance, stroke, were in the hospital for 30 days, it would, you know, pay that and then if something else occurred, you had a heart attack, it would only pay then for 30 days. So yeah.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] So can you see the claim I started?
[AGENT][NEUTRAL] It was under [PII], was that who it was under?
[CUSTOMER][NEUTRAL] Yes, that's my husband and he's still in the hospital, so, um, well, he's been released since for that claim, but he's back in there now.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So it's
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] So let me, so it says, in order to give consideration to the data service, we need an itemized hospital bill.
[CUSTOMER][NEUTRAL] I mean, I have called.
[AGENT][NEUTRAL] With charges fully identified.
[CUSTOMER][NEUTRAL] I mean, I gave them the first, I gave them the page that had the room and board and stuff on it. I didn't go through there and print, you know, the other 98 pages.
[CUSTOMER][NEUTRAL] You know,
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So is that what I'm gonna have to do? You need to tell me what I need to do to be able to file that.
[AGENT][NEUTRAL] Yeah, so we need the itemized receipt showing all of that so it'll show a breakdown as far as the day it shows the uh charges for what was being administered on that day like when they when it says itemized that's what they're talking about.
[CUSTOMER][NEUTRAL] Well, I mean,
[CUSTOMER][NEUTRAL] I got, have you, have you ever had to use a Methodist?
[CUSTOMER][NEUTRAL] And get on that my chart, the Methodist or the getting on there and trying to find what you're asking for is an act of Congress.
[AGENT][NEUTRAL] Mm, yeah, no. Have you tried contacting the, uh, well, you said you can't get a hold of anybody.
[CUSTOMER][NEGATIVE] I have left messages at every Methodist hospital in [PII], numerous messages. Nobody will even return my call.
[AGENT][NEUTRAL] I was gonna say,
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] That.
[CUSTOMER][NEUTRAL] OK, so if I upload 100 pages.
[CUSTOMER][NEUTRAL] Would you think that that will be suffice enough?
[CUSTOMER][NEUTRAL] Cause it's gonna have all of the medicine that they administered to him.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] It's everything.
[AGENT][NEUTRAL] Right, yeah. So, yeah, I mean, that's, that's what it's asking for is the detailed hospital bills. So I know it sounds crazy because it's a lot of pages, but trust and believe that um unfortunately, sometimes I've seen them where there can be claims that are hundreds upon hundreds of pages, unfortunately.
[CUSTOMER][NEUTRAL] And that's crazy that you can't just go down to a medical record.
[CUSTOMER][NEUTRAL] And get a copy
[CUSTOMER][POSITIVE] Without having to go hoops and bounds.
[AGENT][POSITIVE] Mm, yeah, I mean, usually I'll advise people, you know, if they can get a hold of the provider and let them know, hey, I'm trying to find file a claim for my insurance and this is what they're asking for. Most providers will be like, oh, and, you know, they know exactly what you're talking about and then they just will issue it to you and it makes life much easier.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Well I don't know where you're at, but.
[CUSTOMER][NEUTRAL] I'm dealing with [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And the work ethic over here is not there and nobody gives a rats.
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK. Well, I guess I'll try some more and I'll send it and all they'll do is kick back to me and say I need more.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] So as long as I keep sending stuff, they'll keep that case open.
[AGENT][NEUTRAL] It's yeah I mean that's you don't need to resubmit what you did submit you can just submit the additional information.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Well, if I, if I have to go through there and print.
[CUSTOMER][NEUTRAL] It's gonna make me print.
[CUSTOMER][NEUTRAL] Everything
[CUSTOMER][POSITIVE] Everything. So I might as well resubmit everything.
[AGENT][NEUTRAL] You can, for sure. Yeah. I just wanted to let you know it's not required.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Yeah, well, on my chart it makes you.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Print everything.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, OK, well, that's what I needed to know because if you told me it was only gonna be $100.
[CUSTOMER][NEGATIVE] I was gonna say hell I can say that in a month just not by paying for the policy.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] But, OK, well.
[CUSTOMER][NEUTRAL] Let me back up and.
[AGENT][NEUTRAL] Was there anything
[AGENT][NEUTRAL] Yeah, no, not a problem. Did you
[CUSTOMER][POSITIVE] I'll back up and regroup and, and give it a whirl again.
[AGENT][NEUTRAL] You need me to check on anything else today before we go?
[CUSTOMER][NEUTRAL] No, I just wanted to make sure it was gonna pay me enough worth my time and effort and.
[AGENT][NEUTRAL] I hear you.
[CUSTOMER][NEUTRAL] You know, cause I'm having to do all this while I'm at work.
[AGENT][POSITIVE] Yeah, for sure.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] But, alrighty, well, thank you, ma'am.
[AGENT][POSITIVE] You're welcome. Have a blessed day.
[CUSTOMER][POSITIVE] Have a good evening. You too.
[AGENT][NEUTRAL] Uh-huh. Bye-bye.