AccountId: 011433970860
ContactId: 8adb0433-4bb2-4bba-8d5c-95832aef8346
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 229320 ms
Total Talk Time (AGENT): 71635 ms
Total Talk Time (CUSTOMER): 116245 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/8adb0433-4bb2-4bba-8d5c-95832aef8346_20250312T12:41_UTC.wav
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[AGENT][POSITIVE] Good morning thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Oh hi [PII] um I have a question. I, uh, submitted a claim actually just found paperwork, um.
[AGENT][NEUTRAL] Hi.
[CUSTOMER][NEUTRAL] And it says that you need um a to finish the claim processing you need an explanation of benefits from my primary insurance carrier for this.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, and the diagnostic for which treatment was provided, uh,
[CUSTOMER][NEUTRAL] On the date of service.
[CUSTOMER][NEUTRAL] What is that? What is the second one?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so I can help you with your claims and the documents. Um, 1st may I have your name and a good contact number in case we're disconnected?
[CUSTOMER][POSITIVE] Sure, it's [PII].
[CUSTOMER][NEUTRAL] And my number is area code [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you for that. And [PII], may I have your um policy number?
[CUSTOMER][NEUTRAL] Sure. It is 023041887.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify your date of birth, your mailing and email address on file?
[CUSTOMER][NEUTRAL] Sure, [PII], and I believe the email you have is um [PII].
[CUSTOMER][POSITIVE] Get that one or you might have my work one which is [PII].
[AGENT][POSITIVE] Yes, it was the Comcast one and thank you so much for verifying your information. So all the information provided is a verification of benefits, not a guarantee of payment. So the second one is, is asking you for um your diagnosis code. So the easiest thing to do to get that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Do you want that? The diagnose the code?
[AGENT][NEUTRAL] Yes, but you'll have to submit it. We can't take claims over the phone. We'll need it on the, the documentation.
[CUSTOMER][NEUTRAL] OK, so, um, they sent me, um, my, uh, like a paper entitled your surgery benefits, and at the top of it, it has a CPT code and my diagnos diagnostic code. Is that all you need?
[AGENT][NEUTRAL] What's the and it's on the, it has the same data service, which you're looking at?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Uh, OK, so yeah, it has my pre-op appointment which was 33, that was the date that I submitted. See what happened was, um, when I went for my pre-op on [PII], they had me pay for my portion at the office, but the surgery actually took place.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yesterday
[CUSTOMER][NEUTRAL] So on the on the form that I submitted to you all dated [PII] and that was the date of my pre-op that is on the paper.
[AGENT][NEUTRAL] OK, so yeah, as long as it matches [PII] and it has a diagnosis code on it because it's not asking for like an itemized bill or anything. So that should be fine as long as it um lists the code there and has the same [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and I'll also get you the explanation of benefits from my health insurance.
[AGENT][NEUTRAL] Yes, ma'am. And then that should be it.
[CUSTOMER][POSITIVE] OK, sounds good.
[AGENT][POSITIVE] Alrighty. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, that's all.
[AGENT][POSITIVE] Alright, well thank you so much for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] Thank you you too. Bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.