AccountId: 011433970860
ContactId: 70b9f007-2ce8-4aef-8502-87df59ad352e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 253020 ms
Total Talk Time (AGENT): 88201 ms
Total Talk Time (CUSTOMER): 136476 ms
Interruptions: 3
Overall Sentiment: AGENT=1.7, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/02/70b9f007-2ce8-4aef-8502-87df59ad352e_20250502T15:55_UTC.wav
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[AGENT][NEUTRAL] Hello, thanks for calling APL. This, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hey [PII], it's [PII] and Broker Resources. How are you?
[AGENT][POSITIVE] I'm great, [PII]. How are you doing?
[CUSTOMER][NEUTRAL] I'm well. I have um [PII] back on the phone. It sounds like she has been talking to somebody in claims, but she called back and she's um I have a policy number. She's asking about policy number 02477075.
[AGENT][NEUTRAL] Can I have a callback number just in case the call is disconnected?
[CUSTOMER][NEUTRAL] I think it's [PII].
[CUSTOMER][NEUTRAL] Yeah, [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And you did say your name was [PII]. You're a broker from where?
[AGENT][NEUTRAL] From what company?
[CUSTOMER][NEUTRAL] I'm, I'm from APL, yeah, from same, same company, yeah, just broker resources, yeah, this is a different department. She just called us and she just wanted the claims department.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Look, I'm thinking you're one of the brokers.
[AGENT][NEUTRAL] All right, you just don't know what is her name?
[CUSTOMER][NEUTRAL] No, no. Thank you. Her name is [PII].
[AGENT][POSITIVE] Thank you, [PII].
[CUSTOMER][POSITIVE] Yeah, thank you. I hope you have a good day. Happy Friday.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] You do the same. Thank you, same to you.
[CUSTOMER][NEUTRAL] 8
[AGENT][NEUTRAL] Hey, [PII], how are you doing?
[CUSTOMER][NEUTRAL] Alright, I have, oh go ahead sorry.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] This is [PII]. I'll be assisting you. I'm in the claims department. Can I have the member's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, [PII] and her date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And [PII] you're calling from a provider's office?
[CUSTOMER][NEUTRAL] I'm calling from the broker's office.
[AGENT][NEUTRAL] OK, what's the name of the company?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It's uh Crane Atlantis and the and the broker's office is Insurance Services of Palm Beach. [PII] is the broker of records.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] And what was the member's date of birth?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] It shows that the policy was terminated March the first. You're calling about a claim or benefits?
[CUSTOMER][NEUTRAL] Yeah, it's a claim and it was a claim. I just called on it. The data service is 7-17-2024.
[CUSTOMER][NEGATIVE] And it was denied because
[CUSTOMER][NEUTRAL] Of diagnosis codes.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] But, um, the rep had told me I spoke to [PII] and she said we could submit an itemized invoice from Quest. So this claims from Quest. And then I realized after I hung up that I submitted the uh the itemized invoice and it has.
[CUSTOMER][NEUTRAL] It looks like it has codes on there.
[AGENT][NEUTRAL] Do we have the diagnosis code or you have the CPT codes cause the diagnosis codes and CPT codes are completely different from each other.
[CUSTOMER][NEUTRAL] Oh wait let me write that down for the.
[AGENT][NEUTRAL] So let me just verify to see what was submitted.
[CUSTOMER][NEUTRAL] It says CPT code.
[AGENT][NEUTRAL] OK, because if we requested the diagnosis codes, that means that they weren't listed on there, but let me verify for you.
[CUSTOMER][NEUTRAL] OK, yeah, the bill has the CPT codes.
[AGENT][NEUTRAL] Yes, so the diagnosis code starts with a letter, then two numbers, then a period and two more numbers or it may just be a letter and two numbers depending on what was the reason for the visit.
[CUSTOMER][NEUTRAL] OK, so you guys need the diagnosis codes.
[AGENT][NEUTRAL] Yes, which are the ICD 10 codes, the reason for the visit.
[CUSTOMER][NEUTRAL] 3 days.
[CUSTOMER][POSITIVE] Got it. OK. All right, perfect. Thank you for clarifying that.
[AGENT][POSITIVE] You're welcome. Is there anything else that I can assist you with today?
[CUSTOMER][POSITIVE] No that's it for now thank you.
[AGENT][POSITIVE] You're welcome [PII]. It was a pleasure speaking with you. Thanks for calling APL and have a great day.
[CUSTOMER][POSITIVE] Thank you. You too. Bye-bye.
[AGENT][POSITIVE] Thanks, goodbye.