AccountId: 011433970860
ContactId: 5f8a2b59-d6d1-4d04-8b14-6e56ed8ebd1d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 367779 ms
Total Talk Time (AGENT): 107582 ms
Total Talk Time (CUSTOMER): 157133 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/5f8a2b59-d6d1-4d04-8b14-6e56ed8ebd1d_20250124T15:32_UTC.wav
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[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] with the care team and um who am I speaking with? I'm sorry.
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Hey [PII], hey, I have a provider on the line who's wanting information about um.
[CUSTOMER][NEUTRAL] A claim
[CUSTOMER][NEUTRAL] I'm sorry, my brain can't think um I'm looking at policy number 2329818.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let's see here, are you wanting to transfer them?
[CUSTOMER][NEUTRAL] Yeah, so my on-base isn't loading, so I can't answer the rest of his questions. He wants to know what procedure codes were paid and why, um, and the procedure codes listed on the EOB online, um, don't match the procedure codes he said are on the claim, and so I can't do the original claim to help him.
[AGENT][NEUTRAL] OK, what's his name?
[CUSTOMER][NEUTRAL] His name is [PII].
[AGENT][NEUTRAL] [PII], OK.
[CUSTOMER][NEUTRAL] And it's the claim ending in 0026. I verified everything.
[AGENT][NEUTRAL] OK, what is his callback number?
[CUSTOMER][NEUTRAL] Yes, callback number is [PII].
[AGENT][NEUTRAL] OK, you can go ahead and put him first.
[CUSTOMER][POSITIVE] Perfect and I'll introduce you, Miss [PII] if that's OK.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Hi [PII], are you still there?
[CUSTOMER][POSITIVE] Yes. Hey, thank you so much for your patience. I have Miss [PII] on the line and she's gonna take over the call and she'll be able to take care of you, OK?
[CUSTOMER][POSITIVE] OK. Thank you.
[AGENT][NEUTRAL] Hey [PII], this is [PII] in the claims department. How are you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm good. What about you?
[AGENT][NEUTRAL] I'm good. I understand you have questions regarding um a claim number 3380026.
[CUSTOMER][NEUTRAL] Yeah, but she's gave me the different claim one, but I have a [PII] with a different procedure code.
[AGENT][NEUTRAL] OK, um,
[AGENT][NEUTRAL] You said it has different procedure codes?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Um, what procedure codes do you have?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Do you have different procedure codes than what she was pulling up on the claim?
[CUSTOMER][NEUTRAL] Yeah, but I have a 99213008 and 90674. I have a three procedure code.
[AGENT][NEUTRAL] OK, give me just a second here, bear with me.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Let me pull up this claim.
[AGENT][NEUTRAL] Um, OK, so we do not have that claim on file. I don't think the one that you're referring to.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Claim is not on file?
[AGENT][NEUTRAL] No, we do not have that claim on file, the one that you're referring to.
[CUSTOMER][NEUTRAL] Mm, OK, don't have a claim and can you give me the time to file for the claim?
[AGENT][NEUTRAL] There's not gonna be one.
[CUSTOMER][NEUTRAL] Can you give me the mailing address?
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Can you repeat?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] [PII], [PII]. OK, [PII], is correct?
[AGENT][NEUTRAL] No, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] [PII], is correct?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] [PII] uh can you repeat the zip code?
[AGENT][NEUTRAL] Sir,
[CUSTOMER][NEUTRAL] ZIP code?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] One
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] 4
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm. And can you confirm that member active on the data service.
[AGENT][NEUTRAL] Uh, the member was effective [PII] and they turned [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you give me the reference number for this call?
[AGENT][NEUTRAL] It's gonna be my name [PII] and today's date. Is there anything else I can take a look at for you?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] No thank you for giving confirmation. Have a nice day. Take care. Bye.
[AGENT][POSITIVE] OK, well thanks for calling APL you do the same bye bye.
[CUSTOMER][NEUTRAL] That