AccountId: 011433970860
ContactId: 1a2d8dbe-6f5b-408b-b0f4-bb392b13db53
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 482470 ms
Total Talk Time (AGENT): 145646 ms
Total Talk Time (CUSTOMER): 212003 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/30/1a2d8dbe-6f5b-408b-b0f4-bb392b13db53_20241230T15:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello, um, [PII] How I'm calling with questions about my um.
[CUSTOMER][NEUTRAL] About my EOB and my itemized bill that I was gonna upload to file a claim.
[AGENT][NEUTRAL] OK, so you're the insured?
[CUSTOMER][NEUTRAL] Am I, yeah, I'm the insured, yes.
[AGENT][NEUTRAL] And may I have a callback number please?
[CUSTOMER][NEUTRAL] Um [PII].
[AGENT][NEUTRAL] And may I have the policy number?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] One second.
[CUSTOMER][NEUTRAL] Um, 255-2435.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] And [PII], could you please verify your date of birth with me and then the mailing address?
[CUSTOMER][NEUTRAL] OK, date of birth is [PII]. Mailing address is [PII].
[AGENT][NEUTRAL] And we do have an email address on file as well. Could you verify that for me please?
[CUSTOMER][NEUTRAL] Um my first name [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] And thank you so much for verifying your policy. You were trying to submit a claim or what information were you needing?
[CUSTOMER][NEUTRAL] I, I have pre I was, um, I'm about to send one. I just wanted to get this verification from you because, OK, I, I received my EOB.
[CUSTOMER][NEUTRAL] From my um from my um my healthcare provider and then I, I received my itemized yesterday as well. I just want to confirm like, OK, because what I owe on my EOB and um on my itemized is just the breakdown of the whole of the service dates and the, the, the um.
[CUSTOMER][NEUTRAL] So you guys get the uh what I owe right? That's what y'all pay that's on my EOB so it doesn't matter if the itemized what I owe is different from the EOB correct? It's still from the same service days though.
[AGENT][NEUTRAL] As long as the service dates match and the total bill charges matches from the itemized bill in that EOB we go off of what is applied to your deductible, co-insurance, or co-pay.
[CUSTOMER][NEUTRAL] OK, OK, cause it's kinda, it's a little bit different, but my EOB says exactly um what I owe and my itemize all those from the same dates.
[CUSTOMER][NEUTRAL] Um, but, um,
[CUSTOMER][NEUTRAL] The numbers, it has a whole bunch of different numbers on it. That's what I'm just saying. My EOB says what I owe, but my itemize, it has a different, um, a lot of different amounts on it and charges, so I just wanted to know whether or not is that fine for me to still upload cause it's the, it's the correct service dates and everything. It's just the numbers are different. That's why it's confusing me.
[CUSTOMER][POSITIVE] But my EOB says exactly what I owe.
[AGENT][NEUTRAL] Yes, as long as that itemized bill total bill charges equal the amount that is listed on that ELB.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That makes sense.
[CUSTOMER][NEUTRAL] OK, um, that's basically what all I was calling for, um, cause I was gonna submit a claim, a claim soon.
[AGENT][NEUTRAL] OK. Now, on that itemized bill, does it have the ICD 10 code or the diagnosis code? Cause that is gonna be needed as well for submission.
[CUSTOMER][NEUTRAL] OK, um, I believe it, it's a lab slash chemistry codes, but I don't think it has the code you're asking for.
[AGENT][NEUTRAL] OK, if it doesn't have it on there, you will contact the provider that rendered that services and you could just write that on that itemized bill for us to know what that code is.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, so I will have to call my healthcare, right?
[AGENT][NEUTRAL] Whoever the provider that rendered the services, if it was a facility or if it was a physician that you go to.
[CUSTOMER][POSITIVE] Wow.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] OK, and they would give me the code, right? Correct?
[AGENT][NEUTRAL] Yes, you would ask them for an ICD 10.
[CUSTOMER][NEUTRAL] The ICD pin?
[AGENT][NEUTRAL] 10, the number 10.
[CUSTOMER][NEUTRAL] Oh, ICD 10.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And I will have to call the physician.
[AGENT][NEUTRAL] Whoever rendered the services. If you were at a hospital, you will contact them. If it was a doctor's office that submitted you to go to take lab, you will contact the provider that sent you there.
[CUSTOMER][NEUTRAL] OK, and, and will it um.
[CUSTOMER][NEUTRAL] And we'll, is that the same as the DX code?
[AGENT][NEUTRAL] If it's a DX code that is listed on there, that would be the same thing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I have to call um.
[CUSTOMER][NEUTRAL] OK, the physician or the one, OK.
[CUSTOMER][NEUTRAL] And it just curious, would that happens to be like um the one who sent my EOB? I will.
[AGENT][NEUTRAL] That's your insurance.
[CUSTOMER][NEUTRAL] Oh, OK, so I have to call.
[AGENT][NEUTRAL] The doctor.
[CUSTOMER][NEUTRAL] The physician.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Cause he, they, you had to do some lab work.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Yes, it was, um, actually someone on that's on my APL was the um, the dependent. She was hospitalized for a week, so I basically have to get the DS code for what that would be correct.
[AGENT][NEUTRAL] Yes, so who whatever doctor sent her to get the lab test done.
[AGENT][NEUTRAL] Or if she was in the hospital, you will contact the hospital that she was in.
[CUSTOMER][NEUTRAL] OK, OK, that makes sense.
[CUSTOMER][NEUTRAL] OK, OK, so um.
[CUSTOMER][NEUTRAL] Alright, so that's, I guess that's everything. I'll contact them and get that code and do I have to print out the um the form? I forgot what is it called, the um.
[AGENT][NEUTRAL] The midlink claim form.
[CUSTOMER][NEUTRAL] It may link claim form, yes ma'am. That's it. I have to print that out, fill it and write the code on there, right, the DS code.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] You can write it on there as long as it, it's a, it's a spot in there saying description or the reason of the visit, if I'm not mistaken, and you can put it there or you can write it on top of the itemized bill and circle it.
[AGENT][NEUTRAL] But we just have to know that the item that ICD 10 is listed.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, and that is the ICB I mean sorry, can you repeat that? the I.
[AGENT][NEUTRAL] It is I as in igloo, C as in Charles, D as in Delta, and the number 10.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And is there anything else that I can assist you with today, [PII]?
[CUSTOMER][POSITIVE] OK, um, no, ma'am, that's everything thank you so much for your time.
[AGENT][POSITIVE] You're welcome. Thank you for calling American Public Life. Have a great day.
[CUSTOMER][NEUTRAL] OK.