AccountId: 011433970860
ContactId: 554d7214-b6c7-4ebf-b18a-138af19cadd3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 218619 ms
Total Talk Time (AGENT): 116582 ms
Total Talk Time (CUSTOMER): 78202 ms
Interruptions: 2
Overall Sentiment: AGENT=1.4, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/554d7214-b6c7-4ebf-b18a-138af19cadd3_20250325T16:17_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APR. This is [PII]. May I help you today?
[CUSTOMER][POSITIVE] Hi, good. How are you?
[AGENT][POSITIVE] I'm great. How about you today?
[CUSTOMER][POSITIVE] Good, I'm doing great. Um, do you need my policy number?
[AGENT][NEUTRAL] I need your name and your policy number.
[CUSTOMER][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] And my policy number is 02496910.
[AGENT][POSITIVE] Alright, thank you for that information. Now while I'm pulling this up, go ahead and give me a good return telephone call number. I'll see you.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Alright, thank you for all that information. Now go ahead and verify your date of birth and your address for me, please, ma'am.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And it's [PII].
[AGENT][POSITIVE] All right, thank you for all that information, Ms. [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] I am calling in reference to um claim number 358-0275.
[AGENT][NEUTRAL] All right, give me just a moment. Let me get that pulled up. Let's see.
[AGENT][NEUTRAL] All right, I do see that claim pulled up. It is a P1 a claim that you have sent in. Is that correct? How can I help you?
[CUSTOMER][NEUTRAL] I do see that the amount paid is 0. Can you explain to me the reason why?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes ma'am, uh, should, you should see that explanation of benefits, um, on that last page it's gonna tell you that we need uh a diagnosis code from the hospital in writing that uh supports the bill that you submitted.
[AGENT][NEUTRAL] So basically, what I would advise you to do is call that hospital and tell them you want a copy.
[CUSTOMER][NEUTRAL] Mhm mhm.
[AGENT][NEUTRAL] Of your bill that has a diagnosis on it so you can send that in because without that we can't process that claim until we receive that documentation.
[CUSTOMER][NEUTRAL] OK, so when I acquire that document, uh, do I have to resubmit the um paperwork from United or I just.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No, ma'am, you don't have to, but make sure you write that claim number on there so we can identify what that diagnosis has to have that data service on the same information that you send us. So sometimes it's better if you send it all together, but yeah.
[CUSTOMER][NEUTRAL] Sent the.
[CUSTOMER][NEUTRAL] So it has to be like, like a bit.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And um I have a question so um United doesn't provide that to you guys?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Like on the explanation of benefits.
[AGENT][NEUTRAL] No, no, ma'am. Use normally your diagnosis code, uh, just due to HIPAA it's not gonna be on your, your uh ELB um so no, ma'am. The only place you can get that is not from United but from the provider that treated you.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, alright, thanks, um, let me call them thanks.
[AGENT][NEUTRAL] OK. All right.
[AGENT][NEUTRAL] All right. Was that all I can help you with?
[CUSTOMER][POSITIVE] Yeah, that's all thank you.
[AGENT][POSITIVE] Alright, yes ma'am, and thank you for calling APL and you have a great rest of your day, Ms. [PII].
[CUSTOMER][POSITIVE] Thanks bye bye.