AccountId: 011433970860
ContactId: 50b1525b-6b5b-485b-b01d-391cb626138a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 275040 ms
Total Talk Time (AGENT): 119540 ms
Total Talk Time (CUSTOMER): 155471 ms
Interruptions: 3
Overall Sentiment: AGENT=0.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/25/50b1525b-6b5b-485b-b01d-391cb626138a_20250425T21:19_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi how you doing? um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] We submitted a few claims online and you guys requested more information and for the love of Moses I don't, I don't know your portal doesn't let me add the additional information do I have to resubmit all the paperwork again?
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Uh, no, uh uh, no, let, let me have your name and a callback number just in case we get disconnected.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, my name is [PII]. Last name is [PII].
[CUSTOMER][NEUTRAL] And I have a claim number or or a policy number?
[AGENT][NEUTRAL] Policy number, please?
[CUSTOMER][NEUTRAL] It's 022.
[CUSTOMER][NEUTRAL] 03928.
[AGENT][POSITIVE] OK. Thank you.
[CUSTOMER][POSITIVE] Thanks.
[AGENT][NEUTRAL] OK. And for security, may I have your date of birth, mailing address and email address?
[CUSTOMER][NEUTRAL] It's [PII], [PII], and it's uh either [PII] or [PII].
[CUSTOMER][NEUTRAL] I don't know which one I used for you guys.
[AGENT][POSITIVE] OK, thank you, um.
[AGENT][NEUTRAL] All right. Let me just a second, you use the [PII]. OK. Uh, let's see. OK, so, um, oh, let me have a phone number just in case we get disconnected.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, it is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, perfect. Thank you. OK, Mr. [PII], what you can do is submit uh the additional information as a new claim. We'll put that together with what we already have and then we'll process the claim. So you just need to upload the additional information in a separate claim.
[CUSTOMER][NEUTRAL] OK, because all it is is the um all I'm providing is the um.
[CUSTOMER][NEUTRAL] Diagnosis code. So is it, can you add it or no?
[AGENT][NEUTRAL] It has to be a um document. We cannot take it over the phone. Um, so you need to send that document.
[CUSTOMER][NEUTRAL] Can I just, can I just type it can I type up, can I just put a word document that has the diagnosis code referencing the claim number and.
[CUSTOMER][NEUTRAL] Or do you do I have to submit all the paperwork again that's what I'm confused at.
[AGENT][NEUTRAL] OK, when you say all the paperwork, um, do you mean?
[CUSTOMER][NEUTRAL] Like I like I submitted the bill I submitted the bill that we paid.
[CUSTOMER][NEUTRAL] That was from the provider that showed the charges that we're trying to get reimbursed on.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And you guys asked for, so am I just am I just scanning everything again? I guess is the question and and submitting a whole new claim.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] You're not scanning everything again because what you already sent we don't need. OK, so what you're gonna do is.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah, but, but there's two there's two, there's two different claims. So how do you know which one, like, go ahead.
[AGENT][NEUTRAL] We go by the date of service and the provider of service.
[AGENT][NEUTRAL] Um, so,
[CUSTOMER][NEUTRAL] Then I'm resubmitting all the paperwork because OK that's fine. OK, that's fine I I know what to do.
[AGENT][NEUTRAL] uh
[AGENT][NEUTRAL] Oh, OK, so you are submitting a.
[CUSTOMER][NEUTRAL] Well, I have no other way to do this. I have a code R 13.12. That's all I got to submit, but what how am I submitting it? Like, do I, how would you know what it's tied to? That's what I'm asking. Do I, do I write it up in reference to claim number or do I this is where I'm confused.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And that's why I was trying to give you the information on what you need to submit because it's not just like that, it's not just a number that you're gonna send and that's all. um, OK, Mr. [PII], and I do understand your frustration, but let me go ahead and give you the correct information so this don't happen again.
[CUSTOMER][NEUTRAL] OK, so what do you need?
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] OK, so what we're gonna need is the itemized bill with the diagnosis code. So what um you need to do is call the provider of service. Let him know that you're trying to submit your own claim because you already pay out of pocket.
[CUSTOMER][POSITIVE] Good.
[CUSTOMER][NEGATIVE] Alright, alright, I, I got you I got you, OK, yep, uh, that's gonna be a different problem. OK, let me do that. Iize claim with the uh with the diagnosis code. OK, perfect, yep, yep, yeah, OK, thank you so much. No, that's it. This is gonna be a 5 hour process. I'm, I'm gonna kill these providers because they should just file the claims with you guys. I this is such a waste of my time. Alright, thank you, appreciate it.
[AGENT][NEUTRAL] Uh yes.
[AGENT][NEUTRAL] Yes
[AGENT][NEUTRAL] Diagnosis code. It has to have the diagnosis code, OK?
[AGENT][NEUTRAL] Is there anything else I can help you with today?
[AGENT][NEUTRAL] You.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm