AccountId: 011433970860
ContactId: 04bd0a22-1e8f-457f-ac74-ad9c3d72ddae
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 218000 ms
Total Talk Time (AGENT): 99214 ms
Total Talk Time (CUSTOMER): 59601 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/04bd0a22-1e8f-457f-ac74-ad9c3d72ddae_20250305T16:33_UTC.wav
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[AGENT][POSITIVE] Thank you for calling AO this is.
[AGENT][NEUTRAL] May I help you?
[CUSTOMER][NEUTRAL] Um, hey sir, I can barely hear you, um.
[AGENT][NEUTRAL] Is that a little better?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] That's a lot better thank you. um I was calling about a claim that I made and um I'm just trying to figure out what do I need to submit to get a claim paid.
[AGENT][POSITIVE] OK, yeah, let's take a look. Do you have your policy number? I'm happy to help.
[CUSTOMER][NEUTRAL] Yes ma'am, policy number is 2054428.
[AGENT][NEUTRAL] OK, let me pull this up.
[AGENT][NEUTRAL] And then if I could just verify, please, your first, last name and date of birth.
[CUSTOMER][NEUTRAL] [PII]'s birthday is [PII].
[AGENT][POSITIVE] Thank you so much. And then the last thing I'll need to verify is just your address and email, please.
[CUSTOMER][NEUTRAL] Uh, address is [PII], and you said phone number?
[AGENT][POSITIVE] Yeah, uh, email, I'm sorry.
[CUSTOMER][NEUTRAL] Email is um if it's my work email it might be [PII]. Personal email is [PII].
[AGENT][NEUTRAL] Yeah, we have the [PII]. Is that still a good one for you?
[CUSTOMER][POSITIVE] Yeah, that's good.
[AGENT][NEUTRAL] OK. All right. So are we looking at, looks like you had a couple claims submitted this year. Let me pull them up and see what they say here.
[AGENT][NEUTRAL] OK, so.
[AGENT][NEUTRAL] It looks like we need a diagnosis code, and that can be actually um you can get that either from the uh doctor or provider, whoever you've seen. So, you can contact them and just let them know that
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, you need an itemized bill with diagnosis codes on it. Um, these are codes that let us know exactly what you were being seen for and then we're able to pay out the benefit based off of that. You don't need to, um, resubmit everything, [PII], like you don't need to resubmit all the claim forms or anything like that.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, you can submit the doc just that documentation and then we'll go ahead and reprocess the claim.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, itemized bill that shows diagnosis codes, right?
[AGENT][NEUTRAL] Diagnosis codes. Yes, ma'am. Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Gotcha. OK. Well, I will try it again.
[AGENT][NEUTRAL] All right. If you need anything else, please give us a call.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] My pleasure. Take care.
[CUSTOMER][NEUTRAL] Alright you too bye bye.