AccountId: 011433970860
ContactId: 106fa999-e085-4280-a3c8-7d59f8587749
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 634140 ms
Total Talk Time (AGENT): 159512 ms
Total Talk Time (CUSTOMER): 92544 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/23/106fa999-e085-4280-a3c8-7d59f8587749_20250423T17:24_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, um, so, uh,
[CUSTOMER][NEUTRAL] I just got off the phone with theology specialist and they said to talk to you guys.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] there by any chance you can see how much exactly is covered. They give.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] They gave me the billing code so they said that you guys might know what exactly is.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see, let me look into your policy really quick.
[AGENT][NEUTRAL] Um, do you have your policy number?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] 02615114
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right. And then what's your first and last name and date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII] is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And then the address that we have on file?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and your email?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, so the only benefits that I can see are like outpatient inpatient.
[AGENT][NEUTRAL] Um, hospital.
[AGENT][NEUTRAL] They, you said that they gave you a billing code?
[CUSTOMER][NEUTRAL] Yes, there's 3 of them.
[AGENT][NEUTRAL] OK, that's a question for our billing department, uh, let me see.
[AGENT][NEUTRAL] OK, let me transfer you over to our billing department.
[AGENT][NEUTRAL] I have already verified you, so I will let them know that they don't need to do that.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] right
[AGENT][NEUTRAL] OK, just a moment, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Thank you for calling APO. This is [PII]. Can I help you?
[AGENT][NEUTRAL] Hi, yes, [PII], this is [PII] from the care team.
[AGENT][NEUTRAL] Um, I have an insured on the phone, and he is saying that his provider
[AGENT][NEUTRAL] Uh, gave him a bunch of billing codes.
[AGENT][NEUTRAL] And uh we don't do that on our side.
[CUSTOMER][NEUTRAL] It's, it's claims.
[AGENT][NEUTRAL] Oh, is that what he's talking about?
[CUSTOMER][NEUTRAL] Yeah, if he's talking about a provider and some codes that's claims.
[AGENT][NEUTRAL] OK, so it's just a claim number?
[CUSTOMER][NEUTRAL] Yeah, well, I don't know if it's a claim number it might be something that uh the claims needs to give to the provider in order to like file the claim.
[CUSTOMER][NEUTRAL] Probably something on the EOB or something like that, but yeah, that's not group billing.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK. Would that be the, I guess the claims department, but I thought they shut that down.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I don't know how that's processed now that everything's going through the.
[AGENT][NEUTRAL] And
[AGENT][NEGATIVE] I know. I, there's so much that's being processed through that. I forget which one. They shut down. OK.
[CUSTOMER][NEUTRAL] Care team.
[AGENT][POSITIVE] All right. Well, thank you for your help.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] OK, bye.
[CUSTOMER][NEUTRAL] No.
[AGENT][POSITIVE] Hi, thanks for holding. Are you there?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Sorry, I was on mute and I, I forgot I put it on you, but um so the claims department or sorry, the billing department said that this is probably a claim number um can you give me one of those codes they gave you?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] 99203
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That doesn't sound like a claim number, uh.
[CUSTOMER][NEUTRAL] They said there's one
[CUSTOMER][NEUTRAL] One code for the appointment, one for the testing, and one for the intradermal.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, just one moment. I just wanna make sure that.
[AGENT][NEUTRAL] Um, I'm answering your question correctly. OK.
[AGENT][NEUTRAL] Hold on.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, hey, thanks for holding. So I'm reaching out to a colleague on those codes and to see if those look familiar to them. I'm still pretty new, so they don't look familiar to me.
[AGENT][POSITIVE] Um, just a second. Sorry about that.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] What's a good call back number in case our call gets dropped while I'm waiting?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, do you mind if I give you a call back in like 5 minutes? I just don't want you to just wait around.
[CUSTOMER][NEUTRAL] That's
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] All right. And I will talk to you soon once I get an answer on this, OK?
[CUSTOMER][NEUTRAL] Right
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, bye.
[CUSTOMER][NEUTRAL] But