AccountId: 011433970860
ContactId: 018aad4a-b59e-4cc8-8eb0-f70089bbc479
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 317640 ms
Total Talk Time (AGENT): 106381 ms
Total Talk Time (CUSTOMER): 168235 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/018aad4a-b59e-4cc8-8eb0-f70089bbc479_20250326T18:18_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Is this [PII]?
[AGENT][NEUTRAL] Yes, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Hey, um, I'm trying to find out how to do a claim for gap for both [PII] and [PII].
[AGENT][NEUTRAL] Can I have your name and a callback number?
[CUSTOMER][NEUTRAL] Uh-huh. [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] What is the policy number, [PII]?
[CUSTOMER][NEUTRAL] My policy number is 02564453.
[AGENT][NEUTRAL] The callback number that just in case your call is disconnected is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] No [PII].
[CUSTOMER][NEUTRAL] The Last number is [PII].
[AGENT][NEUTRAL] Can you verify your mailing address and your date of birth?
[CUSTOMER][NEUTRAL] Yep, [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Thank you and [PII], you said your name was [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] You're calling with um questions of how to submit a claim. So do you, are you familiar with our AM public online account?
[CUSTOMER][NEUTRAL] Uh, let me see if I have that allied.
[CUSTOMER][NEUTRAL] Let's see, hm.
[CUSTOMER][NEUTRAL] [PII] I guess I'd have to go and register. Is that how I would do it?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK and then.
[CUSTOMER][NEUTRAL] The woman I had talked to previous to you said something about that I needed to have a letter from my providers along with the diagnosis code.
[AGENT][NEUTRAL] You will need an EOB.
[CUSTOMER][NEUTRAL] Uh, is that
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And that should have everything on it, right?
[AGENT][NEUTRAL] Um, no, cause you're gonna need your explanation of benefits from your primary insurance company and then you're gonna need an itemized bill from your, the provider where you receive the services.
[AGENT][NEUTRAL] Cause we're gonna need the diagnosis code in order to process your claim.
[CUSTOMER][NEUTRAL] Yeah, so
[CUSTOMER][NEUTRAL] So one of them for [PII] there is a charge from my.
[CUSTOMER][NEUTRAL] Uh, skin doctor.
[CUSTOMER][NEUTRAL] And I have a description like I have a broken down bill for $580.77.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It shows what the, my insurance, um, adjust, it shows the insurance adjustment on it. Um, it shows like it says moles, micrographic, you know, whatever, it was skin surgery.
[CUSTOMER][NEUTRAL] So it shows that there are some codes prior to the description like 17110 17,000 17311. Do you think those are the codes?
[AGENT][NEUTRAL] Those are CPT codes. No, ma'am. So, ICD codes or no, no, they're not. Those are CPT codes. Those are the procedure codes.
[CUSTOMER][NEUTRAL] They are? OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] The ICD code is gonna start with a letter and then numbers.
[AGENT][NEUTRAL] It's gonna be the reason for your visit.
[CUSTOMER][NEUTRAL] OK, and so and.
[CUSTOMER][NEUTRAL] Do I just call them and tell them I need a bill with the diagnosis codes?
[AGENT][NEUTRAL] Yeah, you just call them and request the itemized bill with the diagnosis listed for your insurance company.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Because I do have an EOB for that particular doctor, you know, that matches up.
[AGENT][NEUTRAL] Mhm, but you're still gonna need the the diagnosis codes. We need those in order to process the claims to know what was the reason that you was there because your policy doesn't cover like preventative services, so we need to know if it's the sickness or preventative services.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right, and so can they just put that in a note or it needs to go on this bill?
[AGENT][NEUTRAL] It has to be an itemized bill.
[CUSTOMER][POSITIVE] OK, alright, well let me get on the phone and talk with them. I appreciate it.
[AGENT][NEUTRAL] You're welcome. And also, if you don't want to submit your claim online, you can send it to us by fax or mail.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, I'll put it through online. I just need to get everything together and.
[CUSTOMER][NEUTRAL] Scan it to my email and then get it out.
[AGENT][POSITIVE] Alrighty, well, if you get to a stopping point and you need some assistance, give us a call. Thanks for calling APL and have a great day.
[CUSTOMER][POSITIVE] All right, thanks so much.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][POSITIVE] You're welcome, bye.