AccountId: 011433970860
ContactId: 35aa77e1-c407-44aa-8b68-25b8cd4756fb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 453190 ms
Total Talk Time (AGENT): 104024 ms
Total Talk Time (CUSTOMER): 187404 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/35aa77e1-c407-44aa-8b68-25b8cd4756fb_20250605T20:00_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, um,
[CUSTOMER][NEUTRAL] My name is [PII], and I've got a letter here for uh claim number 36.
[CUSTOMER][NEUTRAL] 03953
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] My husband is [PII]. He's the one that's insured.
[AGENT][NEUTRAL] OK. And give me one moment. Ms. [PII], do you have a policy number?
[CUSTOMER][NEUTRAL] Uh, yes, 02408.
[CUSTOMER][NEUTRAL] 856.
[AGENT][NEUTRAL] OK. And verify your date of birth and the mailing address for me, please.
[CUSTOMER][NEUTRAL] It's [PII] and the mailing address is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And I'm showing that claim it looks like you're needing, give me one moment.
[AGENT][NEUTRAL] Uh, it looks like they're needing the EOB and the diagnosis code for the data service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me see if uh there's some codes here.
[CUSTOMER][NEUTRAL] There's one code.
[CUSTOMER][NEUTRAL] 380.
[CUSTOMER][NEUTRAL] 2053.
[AGENT][NEUTRAL] I'm not sure what that code is, but it's not a diagnosis code. Um.
[AGENT][NEUTRAL] So you may have to contact the provider, looks like it's Willis N and Health and request itemized bill with the diagnosis and procedure codes.
[CUSTOMER][NEUTRAL] They, they did, they did. That's what I'm looking at, um.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] That's what I'm looking at. I just need to know how to send it to y'all.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Uh, you can mail it or fax it to us, or if your husband is set up on the online service center, he can upload into the system.
[CUSTOMER][NEUTRAL] Well, yeah, I got it at home. He's at work and I keep trying to take a picture of it to send to him and it's uh too blurry to see.
[AGENT][NEUTRAL] OK, so best bet is to either fax it or mail it into us and along with the billing, we need the primary EOB for that data service.
[CUSTOMER][NEUTRAL] Primary EOV.
[AGENT][NEUTRAL] Uh yes, ma'am.
[CUSTOMER][NEUTRAL] You're gonna have to speak in uh.
[AGENT][NEUTRAL] It's called an explanation of benefits. It's what your primary insurance was showing for a specific date of service, how they process the claim.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh shoot noodles.
[CUSTOMER][NEUTRAL] Can you give me a fax number?
[AGENT][NEUTRAL] Yes, ma'am. Uh, fax number is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] 3.
[CUSTOMER][NEUTRAL] [PII] 3.
[CUSTOMER][NEUTRAL] OK and who am I directing this to?
[AGENT][NEUTRAL] Uh, clients department.
[CUSTOMER][NEUTRAL] Claims department.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, I'll go ahead and I'll fax this and
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So I just put it with you to reference number, uh, so y'all can get it.
[AGENT][NEUTRAL] You can reference that claim number if you like.
[CUSTOMER][NEUTRAL] Claim number.
[CUSTOMER][NEUTRAL] OK, claim number.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK, so do I need to send you the letter too that y'all sent so y'all can know it or just that uh [PII]'s uh explanation.
[CUSTOMER][NEUTRAL] Of the uh uh they they sent me just one page it has.
[CUSTOMER][NEUTRAL] EEG, uh, sleep study and then it has payment, uh, adjustments, refund information.
[CUSTOMER][NEUTRAL] So that should be all that you need.
[AGENT][NEUTRAL] I'm not sure because I don't know if it shows it has a diagnosis code.
[CUSTOMER][NEUTRAL] Well, they've got another uh.
[CUSTOMER][NEUTRAL] They got one that says code and then they have one that says um CJ 407 it's a long thing.
[AGENT][NEUTRAL] No, ma'am, diagnosis code and I also say ICD 10 code. So you may have to contact that provider billing department and request the billing with the diagnosis code.
[CUSTOMER][NEUTRAL] As insurance policy.
[CUSTOMER][NEUTRAL] And that
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] You don't make this easy. I'm sorry to say.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] All right. So tell me again what's the uh name of that code I need? I see what?
[AGENT][NEUTRAL] I see D as in David, 10.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] So I'm gonna fax this and uh.
[CUSTOMER][NEUTRAL] Call back and see if uh.
[CUSTOMER][POSITIVE] That works so I can uh.
[CUSTOMER][NEGATIVE] Shake it.
[CUSTOMER][POSITIVE] All right. Uh, thank you very much for your help.
[AGENT][POSITIVE] Uh, you're welcome. Thank you for calling APL. Have a great day.
[CUSTOMER][POSITIVE] Thank you. Bye now.