AccountId: 011433970860
ContactId: ea349fd9-9e94-4789-9a8a-b53846d8023f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 295859 ms
Total Talk Time (AGENT): 129633 ms
Total Talk Time (CUSTOMER): 108468 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/20/ea349fd9-9e94-4789-9a8a-b53846d8023f_20250220T14:54_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling ATL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] I you had a question regarding a claim.
[AGENT][NEUTRAL] OK, sure. I can assist you with claims.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, I have a number for uh.
[AGENT][NEUTRAL] Go ahead with the policy number.
[CUSTOMER][NEUTRAL] I own the policy but I have the um the claim number.
[AGENT][NEUTRAL] OK, go ahead with the claim number.
[CUSTOMER][NEUTRAL] 356-618-8
[AGENT][NEUTRAL] May I have your name and a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah, first name [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And that is [PII].
[AGENT][NEUTRAL] Thank you, one moment, let me pull this information.
[AGENT][NEUTRAL] OK, Mr. [PII], um, for security, may I have your date of birth, mailing address, and email address on file?
[CUSTOMER][NEUTRAL] Yeah, so, uh, [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The address is, um.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] In RPMS.
[CUSTOMER][NEUTRAL] It was the last uh?
[AGENT][NEUTRAL] And the email address?
[CUSTOMER][NEUTRAL] What's the last one you asked me? Oh, I'm sorry, yes.
[AGENT][NEUTRAL] Email address.
[CUSTOMER][NEUTRAL] So the email address is uh [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I see that um they're needing a fully itemized bill to process this claim.
[CUSTOMER][NEUTRAL] Yeah, OK. So I just went on, so what I did is I just went on the gateway.
[CUSTOMER][NEUTRAL] My um
[CUSTOMER][NEUTRAL] My, um, in this case, it's Massachusetts General Hospital.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] And I just did a records request.
[CUSTOMER][NEUTRAL] And I requested that they send them directly to you. I use that fax number.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] I think it was 365.
[CUSTOMER][NEUTRAL] I have in the other room, but, um.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's, that's usually the best way to process this, right?
[AGENT][NEUTRAL] But
[AGENT][NEUTRAL] Uh, well, the medical records has a lot of information, but the medical records doesn't have charge amount. So, um, and that's why we asked for a fully itemized bill because the itemized bill is gonna have, uh, the charge amount is gonna have the diagnosis codes, procedure codes, and anything they did while you were in the, in the hospital. Um, so we, I think we're still gonna need that because we need the charge amounts. We need to know how much um is being charged.
[CUSTOMER][NEUTRAL] Yeah, yeah, OK, how would I get, how will I get that, uh.
[AGENT][NEUTRAL] Um, you just let them know that you're trying to submit your own claim and you need a fully itemized bill with diagnosis codes or if you have, um, they can give you like a UBO4 form, that's what it's called.
[CUSTOMER][NEUTRAL] OK, UVO4 and just asking for that.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, mhm, and if they say they can send it directly to us, they can go ahead and send it by fax as well, OK?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Alright, and that best fax number is the one that was on, um.
[AGENT][NEUTRAL] Uh, the, in the back of the card which is the [PII].
[CUSTOMER][NEUTRAL] Yeah, that's the one I sent it to, OK, so.
[AGENT][NEUTRAL] Mhm, mhm. Yeah.
[CUSTOMER][NEUTRAL] So I asked them for UVO4 that has all the itemized and they'll send that directly to you.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Correct, yes, that has everything we need. Mhm.
[CUSTOMER][NEUTRAL] OK, so I gotta, so I need to actually talk to them directly.
[AGENT][NEUTRAL] Mhm. Yes, yes, because the medic.
[CUSTOMER][NEUTRAL] So everything they're gonna be sending.
[AGENT][NEUTRAL] Uh-huh, go ahead.
[CUSTOMER][NEUTRAL] So everything they're gonna be sending you is gonna be uh.
[CUSTOMER][NEUTRAL] You probably don't need it.
[AGENT][NEUTRAL] The, the medical records.
[CUSTOMER][NEUTRAL] Because I checked all the boxes they wanted like abs.
[AGENT][NEUTRAL] Yeah, um, yeah, that's usually whenever it's something major and we need to um get a little bit more details about what happened, then we get uh request medical records, but we don't need medical records. Uh, what we need is a fully itemized bill. Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, for the 4 days, alright, uh, 7 days I was there.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Alrighty let me uh let me call him now.
[AGENT][NEUTRAL] All right. Is there anything else I may help you with today, Mr. [PII]?
[CUSTOMER][NEGATIVE] No thank you.
[AGENT][POSITIVE] Yeah you're welcome. Thank you for calling ATO have a good day.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][POSITIVE] Thank you, bye bye.