AccountId: 011433970860
ContactId: 28f3686b-6fae-440f-87a0-2b3ac77e9b7c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 209020 ms
Total Talk Time (AGENT): 39862 ms
Total Talk Time (CUSTOMER): 79156 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/20/28f3686b-6fae-440f-87a0-2b3ac77e9b7c_20250520T21:21_UTC.wav
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[AGENT][NEUTRAL] No, thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey Miss [PII], it's [PII] on the care team. How you doing?
[AGENT][POSITIVE] I'm good how are you?
[CUSTOMER][NEUTRAL] I'm good. Um, I might not have to transfer this to you. If a wellness claim is being denied, um.
[CUSTOMER][NEUTRAL] Saying that it wasn't a wellness, but it's a physical and they did a colon cancer screening too. How, what do they need to put on the claim form to let us know that
[CUSTOMER][NEUTRAL] A cancer screening was done.
[AGENT][NEUTRAL] What is the policy number?
[CUSTOMER][NEUTRAL] Like, do they need to just ride it in?
[CUSTOMER][NEUTRAL] It is 425102.
[AGENT][NEUTRAL] Part one.
[CUSTOMER][NEUTRAL] Um, this, yes, this is for part one.
[AGENT][NEUTRAL] And was there a particular claim number? I know she got 5 of them.
[CUSTOMER][NEUTRAL] Um, it's the, hold on, let me go back.
[AGENT][NEUTRAL] I mean, I'm sorry, 33 or 4 they deny it.
[CUSTOMER][NEGATIVE] It's all three that denied for the 201 reason.
[CUSTOMER][NEUTRAL] Cause on the claim, I looked on um on base, on the claim form, she did check it's a physical um or routine physical.
[AGENT][NEUTRAL] OK, so it's going
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] She didn't put anything about cancer, but she said she called the doctor and the doctor said, well, I do, um, the the colon cancer screenings with your physical.
[CUSTOMER][NEUTRAL] Um, so she's trying to figure out how to
[CUSTOMER][NEUTRAL] Let us know that.
[AGENT][NEUTRAL] Let me see what was sending. Give me one second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, so it looks like they did not mark on the form that they have a cancer screening test done.
[AGENT][NEUTRAL] Uh, on the form they just.
[CUSTOMER][NEUTRAL] Right, that's my question.
[CUSTOMER][NEUTRAL] She just my routine physical. Does she need to write in that a a colon cancer uh screening was done as well, or that's my question.
[AGENT][NEUTRAL] Uh, yeah, that's the only way that we're gonna know that they have one done.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Thank you. I just never had that question before.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] And I didn't see any other documents except the claim form.
[AGENT][NEUTRAL] Yeah, on that claim form, all they gotta do is put it in, so she just got put on there that she had it done and the day she had it done.
[AGENT][NEUTRAL] So other other than that we won't know alright.
[CUSTOMER][POSITIVE] OK, I'll let her know. Thank you.
[CUSTOMER][NEUTRAL] All right, bye-bye.