AccountId: 011433970860
ContactId: e3a7f699-9020-493c-8488-159da9ca4a49
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 260839 ms
Total Talk Time (AGENT): 117620 ms
Total Talk Time (CUSTOMER): 105463 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/18/e3a7f699-9020-493c-8488-159da9ca4a49_20250618T20:29_UTC.wav
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[AGENT][POSITIVE] Thank you for contacting ATL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi. Hi, um, I have started a claim right after I had a surgical procedure.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I guess it was back in.
[CUSTOMER][NEUTRAL] April at the end of April and.
[CUSTOMER][NEUTRAL] The um claim stated that I needed to, like, once it was reviewed, I needed to submit my explanation of benefits from the insurance. I just got that from my insurance like a couple of days ago.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um, and I was trying to submit, but the claim says process. When I go into download my documents, it says I need to submit the explanation of benefits, but I no longer have access to add documents to that claim.
[AGENT][NEUTRAL] OK, let's go ahead and look at your policy and see what needs to be done. What is your policy number, please?
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] 1070226
[AGENT][NEUTRAL] Thank you. I can verify your name and date of birth and the phone number, please?
[CUSTOMER][NEUTRAL] [PII], [PII], [PII].
[AGENT][POSITIVE] OK, thank you very much. I'm just looking at this now.
[AGENT][NEUTRAL] OK, so what we're talking about is the data service um.
[AGENT][NEUTRAL] For uh
[AGENT][NEUTRAL] [PII], is that correct?
[CUSTOMER][NEUTRAL] Wait, I, I couldn't hear you. What?
[AGENT][NEUTRAL] Yes, uh, this is for [PII], is that correct?
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] I, I guess maybe that's when I.
[AGENT][NEUTRAL] It looks like there's um it looks.
[AGENT][NEUTRAL] Yeah, it looks like there is a Mount Sinai um uh facility.
[CUSTOMER][NEUTRAL] Yeah, it's from Mount Sinai. It was for, for surgery, the surgery I had.
[AGENT][NEUTRAL] Yeah, that was in February
[AGENT][NEUTRAL] And, and what was your surgery?
[CUSTOMER][NEUTRAL] And actually
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, I had
[CUSTOMER][NEUTRAL] I had colon surgery. They had to go in and remove a part of my colon.
[AGENT][NEUTRAL] Oh, I'm sorry to hear that. Um, well, I, what I have, the last thing that I have that is available, [PII], uh, it's, there are two dates of service. One of them is [PII] and one of them is [PII]. Now both of those are are waiting for your explanation of benefits.
[AGENT][NEUTRAL] Um, I can tell you how to get online to, to, uh, um.
[AGENT][NEUTRAL] Submit them we just updated our online service center and so uh there's, um, you have to go in and create a new a new account and so I can tell you how to do that so that you can submit the um so you can submit your explanation of benefits.
[CUSTOMER][NEUTRAL] I'm, I'm online right now on the site unless it's a different site.
[AGENT][NEUTRAL] OK, and, and what, what part of the, um, how far have you gotten into the side?
[CUSTOMER][NEUTRAL] I, I submitted all of my original paperwork and the claim form online.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] So we're gonna go ahead and we're gonna create.
[CUSTOMER][NEUTRAL] But now
[AGENT][NEUTRAL] Yeah, go ahead.
[CUSTOMER][NEUTRAL] So I have to I have to create a new claim.
[AGENT][NEUTRAL] Well, yes, what we're, what you're going to do is you're going to sit, you're going to submit this differently. You don't need to add it to the claim that was already processed. You're just going to send it in separately and then we will add the two documents together.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] Now, is there anything, do you have any questions about submitting the claim? Is there anything else that I can help with?
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] I don't think so. I, and I have to fill.
[CUSTOMER][NEUTRAL] I have to fill out that claim form.
[AGENT][NEUTRAL] No, no, it looks like you did to begin with. all you have to do is submit that to us.
[CUSTOMER][NEUTRAL] Yeah, I did.
[AGENT][NEUTRAL] Right.
[CUSTOMER][POSITIVE] Perfect, perfect, yeah, I I see it. I can see where I can just upload the file now.
[AGENT][NEUTRAL] Yes, and so you'll just, you'll just upload it onto the system and um uh then uh we will go ahead and add, we'll add the documents to the to the stuff that you've already uh submitted to us and then continue processing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] Oh wonderful. Thank you so much for your help.
[AGENT][NEUTRAL] OK, there's nothing I can help with, thanks for contacting API.