AccountId: 011433970860
ContactId: 1f955fa3-1021-4155-9882-9053548120cc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 376160 ms
Total Talk Time (AGENT): 110053 ms
Total Talk Time (CUSTOMER): 83918 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/25/1f955fa3-1021-4155-9882-9053548120cc_20250425T17:03_UTC.wav
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[CUSTOMER][NEUTRAL] First time we had a uh
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I was calling.
[CUSTOMER][NEUTRAL] Um hoping that
[CUSTOMER][NEUTRAL] You could uh help me with.
[CUSTOMER][NEUTRAL] Either a resubmitting a claim so that we can get it paid or.
[CUSTOMER][NEUTRAL] Uh, be explaining to me why something wouldn't be covered.
[AGENT][NEUTRAL] OK, yes, OK.
[CUSTOMER][NEUTRAL] This is my usually are usually the provider submits the claims for us um but the one I'm trying to submit.
[CUSTOMER][NEUTRAL] They say that they won't so I'm trying to submit it.
[CUSTOMER][NEUTRAL] I submitted it like last week and it says.
[CUSTOMER][NEUTRAL] You know it's processed and whatnot, $0 amount paid so I'm just a little confused why.
[AGENT][NEUTRAL] OK, yes, I can look that up for you. Do you have the policy number?
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Maybe second.
[CUSTOMER][NEUTRAL] I gotta log in real quick.
[AGENT][NEUTRAL] OK. No, you're fine.
[AGENT][NEUTRAL] What's a good call back number in case our call gets dropped?
[CUSTOMER][NEUTRAL] [PII] I believe.
[AGENT][NEUTRAL] OK. And then what's your date of birth?
[CUSTOMER][NEUTRAL] Mine is [PII].
[AGENT][NEUTRAL] OK, I have you pulled up.
[AGENT][NEUTRAL] OK, and then what's a good call back number in case our call gets dropped?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] OK, [PII], can you verify the mailing address we have on file?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and your email address?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] [PII] or [PII].
[AGENT][NEUTRAL] OK, it looks like we have a different email on file. Did you wanna update that?
[CUSTOMER][NEUTRAL] What is on file?
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII]. Yeah, that's my work one. That one's fine.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Oh, OK, we'll leave that then.
[AGENT][NEUTRAL] OK, and then do you have the claim number for the claim you're trying to look for?
[CUSTOMER][NEUTRAL] 359.
[CUSTOMER][NEUTRAL] 1767
[AGENT][NEUTRAL] OK. Just a second.
[AGENT][NEUTRAL] Is this claim for you or your spouse?
[CUSTOMER][NEUTRAL] It's for my son.
[AGENT][NEUTRAL] OK, just a second.
[AGENT][NEUTRAL] OK, and then what's your son's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. And then his date of birth, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Have to wait
[AGENT][NEUTRAL] OK. So it looks like this claim was denied because there was no diagnostic diagnostic codes.
[AGENT][NEUTRAL] On the forms that you sent in.
[CUSTOMER][NEGATIVE] OK, so how the hell do I get those?
[AGENT][NEUTRAL] Uh, so you're just gonna call your provider and just ask for an itemized bill and an EOB and that will have the diagnosis codes on, on them.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] OK, yes, so we need those diagnosis codes that way when it goes into our claim support, they will look at, look at your documents and those codes, that's what determines whether it's approved or not.
[AGENT][POSITIVE] So just call your provider and let them know and they'll know exactly what you're talking about.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, sounds good. Thank you.
[AGENT][NEUTRAL] Yeah, is there anything else I can help you with?
[CUSTOMER][NEUTRAL] I don't think so right now.
[AGENT][POSITIVE] OK. Well, thanks for calling APO. Have a good day.
[CUSTOMER][POSITIVE] You too. Thanks, bye.
[AGENT][NEUTRAL] OK