AccountId: 011433970860
ContactId: 4cd0a5aa-c174-4e1e-bcfb-7714fa91abf8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 212139 ms
Total Talk Time (AGENT): 112582 ms
Total Talk Time (CUSTOMER): 70606 ms
Interruptions: 2
Overall Sentiment: AGENT=0.4, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/4cd0a5aa-c174-4e1e-bcfb-7714fa91abf8_20250219T17:56_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling APO. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hey, I have a question about a couple of claims that I submitted that are asking for uh diagnosis codes.
[AGENT][NEUTRAL] OK, and your name is?
[CUSTOMER][NEUTRAL] [PII]?
[AGENT][NEUTRAL] OK, and Mr. [PII], what is that policy number, please?
[CUSTOMER][NEUTRAL] Oh, let's see what's my policy number 02282936.
[AGENT][NEUTRAL] OK, and give me a moment.
[AGENT][NEUTRAL] And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yep, it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and verify your date of birth, mail address and email address.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, email address [PII]. And what was the other thing you asked me for?
[AGENT][NEUTRAL] 314. Uh, mailing address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And you say you're calling about claims that are requesting the diagnosis code?
[CUSTOMER][POSITIVE] Yeah, that's correct.
[AGENT][NEUTRAL] OK, do you happen to have the claim number or the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, we'll start, we'll start with the claim number or with this 1, uh 355.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 983 4.
[AGENT][NEUTRAL] 34. OK, see.
[AGENT][NEUTRAL] OK, was this for [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and let me look at this claim.
[AGENT][NEUTRAL] Uh, yes, sir. It looks like for this data service, where there's several data service on here, um.
[AGENT][NEUTRAL] It looks like it all started with [PII].
[AGENT][NEUTRAL] And they are needing, I'm sorry?
[CUSTOMER][POSITIVE] That should be right.
[CUSTOMER][POSITIVE] That should be right, yeah.
[AGENT][NEUTRAL] Uh, yes, sir. They're needing the diagnosis code for that data service. Uh, the diagnosis code is the reason for, looks like he was hospitalized.
[CUSTOMER][NEUTRAL] Yeah, he was hospitalized. So, I uploaded.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] An EOB.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Is that what's needed?
[AGENT][NEUTRAL] No, uh, the EOB is what you would get from your major medical insurance company. The diagnosis code is something you would get from the physician or the hospital, um.
[CUSTOMER][NEUTRAL] Yep, OK.
[CUSTOMER][NEGATIVE] Oh jeez, OK.
[AGENT][NEUTRAL] For the hospital, you can contact the billing department and request an admit and discharge time and some admit and discharge summary, and it should have a diagnosis code on there.
[CUSTOMER][NEUTRAL] OK and then how do I submit that to APL?
[AGENT][NEUTRAL] Uh, you can mail it, fax it, or if you set up on the online service center, which it looks like you have, you can upload the claim as a new claim.
[CUSTOMER][NEUTRAL] Yeah, I am.
[CUSTOMER][NEUTRAL] So just upload that as a new claim, OK, so I need to get an admitted discharge form.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Uh, summary, yes, sir. It will show when he was admitted, discharged, but it also had the diagnosis or description of the diagnosis on there.
[CUSTOMER][POSITIVE] We're cool summary.
[CUSTOMER][NEUTRAL] OK, I wonder if that's also on a bill, which I don't. OK, cool. I will get that from them and I will upload it.
[AGENT][NEUTRAL] OK. And is there anything else I can assist you with? OK.
[CUSTOMER][NEUTRAL] That was it. That's all, that's the only question I have.
[CUSTOMER][NEUTRAL] No, that's the only questions I have. Thank you.
[AGENT][POSITIVE] You're welcome. Thank you for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] Bye bye.