AccountId: 011433970860
ContactId: 2d124589-366c-48ea-bc08-7ef23037b95d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 345519 ms
Total Talk Time (AGENT): 145879 ms
Total Talk Time (CUSTOMER): 139411 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/17/2d124589-366c-48ea-bc08-7ef23037b95d_20250217T19:49_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII], and I got a letter from you over the weekend about needing some more information, but I have a question so you can complete a claim.
[CUSTOMER][NEUTRAL] But I have questions to make sure I get the right thing to you.
[AGENT][POSITIVE] OK, um, I'm happy to take a look and help. Do you have the claim number, policy number, anything like that?
[CUSTOMER][NEUTRAL] Yeah, and the claim number is 3562288.
[AGENT][NEUTRAL] Alright, let me pull this up here. One second.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Because I thought I attached what they they sent me. I don't know if you guys got that.
[CUSTOMER][NEUTRAL] I want to make sure and I called them back and they're like what you got is what we give. It has the codes on it and I was like I don't know I'm just.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The in between.
[AGENT][NEUTRAL] All right. And then, [PII], let me just verify please your date of birth and address.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, [PII] and my address is [PII].
[AGENT][POSITIVE] Alright, thank you so much. So let's see.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] All right. So yeah, it looks like it's saying in order to give consideration for your claim, we need fully itemized surgery bill that includes procedure and diagnosis code. And they're saying that's what they gave you, correct?
[CUSTOMER][NEUTRAL] Yeah, it says I'm looking at it. It says procedure codes and diagnostic codes.
[AGENT][NEUTRAL] OK. Let me pull it up and just double check here. Give me a
[CUSTOMER][NEUTRAL] So I'm like maybe I didn't upload it correctly.
[AGENT][NEUTRAL] Yeah, let's let me take a look and see what we had on our side here, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEGATIVE] I think I did it all on my phone, so it might not have worked.
[AGENT][NEUTRAL] Yeah, if it was maybe missing a sheet or we'll see here.
[CUSTOMER][NEUTRAL] Yeah, after that I'd start with you guys first. I, well, I've been on the phone with them all day. I'm like, where's the nobody can give me the surgeon, um.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Number and this old lady helped me on billing and she gave me the wrong number.
[CUSTOMER][NEUTRAL] And I'm still back to I don't I do have the name of who put me under, but I gotta find his number.
[AGENT][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I said I've received no bills from any of y'all.
[AGENT][NEUTRAL] OK, yeah, I see that it looks like, I mean there were a few line items at the top that didn't have CPT codes, but it looks like the majority of it did on the bill from them.
[CUSTOMER][NEUTRAL] Like the 3rd page is where I'm seeing them 3 of 3.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] So what I
[CUSTOMER][NEGATIVE] Like maybe I didn't even send it.
[AGENT][NEUTRAL] Yeah, so what I have that I show was uploaded is just it shows Baylor Scott and White Health 12725 itemized statement and it says this is not a bill it's an itemized of your services and then there's like um just two pages it looks like with charges and then it has diagnosis was that what you had sent?
[CUSTOMER][NEUTRAL] No, I'm looking at something totally different, so maybe I need to send this what I'm looking at because it says, um, on the 3rd page.
[CUSTOMER][NEUTRAL] Recommendation procedure codes 43235 and then diagnostic codes, yeah, and it has like 13 that's what you need.
[AGENT][NEUTRAL] There we go.
[AGENT][NEUTRAL] 432
[AGENT][NEUTRAL] Yeah, that's
[AGENT][NEUTRAL] That's what we need that's not what I see over here. So yeah, if you can upload that, that should be.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Upload that. And then the surgery, I still need the anesthesiologist one, right?
[AGENT][POSITIVE] Good.
[AGENT][NEUTRAL] Uh yes. Uh-huh.
[CUSTOMER][NEUTRAL] Cause this won't say anything about that in here. I don't see anything with that in here.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yeah, I don't see anything either on here, so yes, for that you would wanna um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] See if you could reach out to that anesthesiologist and see if they could give you that breakdown.
[CUSTOMER][NEUTRAL] OK, I'll do that and then I can send this all together. I just, um, when I log in, can I upload it or do I start over?
[AGENT][NEUTRAL] Mhm, mhm.
[AGENT][NEUTRAL] Yeah, no, you can just you can just upload it and it'll continue on with your claim and you can write the claim number on there if you want to.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, OK, well, I appreciate your help.
[AGENT][POSITIVE] Yeah, not a problem. Anything else I can do for you?
[CUSTOMER][NEUTRAL] No, just trying to handle this business.
[AGENT][POSITIVE] All right, done, not a problem.
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You're welcome. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.