AccountId: 011433970860
ContactId: aaebc088-2d27-4e67-996b-705cd6ebb3e7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 172059 ms
Total Talk Time (AGENT): 108775 ms
Total Talk Time (CUSTOMER): 78189 ms
Interruptions: 2
Overall Sentiment: AGENT=1.2, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/aaebc088-2d27-4e67-996b-705cd6ebb3e7_20250203T22:42_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. You're speaking with BSC. How may I help you today?
[CUSTOMER][NEUTRAL] Hello, Ms. [PII], this is [PII]. Ms. [PII], I have policy number 2,504,230.
[AGENT][NEUTRAL] I, uh-huh.
[AGENT][NEUTRAL] Wait a minute, hold on. Give it to me again. Give it to me again.
[CUSTOMER][NEUTRAL] 2,504,230
[AGENT][NEUTRAL] Alright, and this is 4.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Uh, it's a HI policy. I don't know how y'all get me in the HIQ, but I'll do my best.
[CUSTOMER][NEUTRAL] And I have
[CUSTOMER][NEUTRAL] There's not a, there's nobody for an HIQ so I hit the, hit the C A D I I C H life.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. I do try to help her, but, uh, I don't think that's gonna be, let me see what they denied it for.
[CUSTOMER][NEUTRAL] There's
[CUSTOMER][NEUTRAL] They did not they're just saying they need some additional information on her EOB.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, in order to complete the, we need an itemized statement. They need the itemized bill. OK, I can tell that. Mhm, need to itemize.
[CUSTOMER][POSITIVE] You are wonderful. Everything has been verified and updated.
[AGENT][POSITIVE] OK, thank you. Bye.
[CUSTOMER][POSITIVE] Thank you, love. Have a good day. Bye, Ms. [PII].
[AGENT][NEUTRAL] You too. Bye.
[AGENT][NEUTRAL] Hello, Mrs. uh [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] This is [PII] in the claims department. How can I help you today?
[CUSTOMER][NEUTRAL] Hi, I'm calling because I uh submitted uh a statement.
[CUSTOMER][NEUTRAL] And uh an exclamation of benefits came back saying that they needed an itemized diagnostics, diagnostics code. And right on the statement, it has the numbers.
[AGENT][NEUTRAL] OK. Yeah, that's the CPT code. They need the diagnosis code. Diagnosis code is what you're treating for, what type of sickness you're treating for.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] And that's why they need the itemized bill. Those codes you got 99213, that's an office visit. 11305, that's some kind of surgery. 1102 is some type of surgery, but we don't know what you, what your sickness was, so we need the diagnosis code and it would be on an itemized uh bill. So what you send in, they can't use it because they don't have the diagnosis code.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so I have to call the doctor's office and get it?
[AGENT][NEUTRAL] Uh, I, I, I'm just telling you what they said, they need an itemized bill. You would have to, I'm sure your doctor would know what she was treated for. So you would need to submit the itemized bill with the diagnosis codes on it.
[CUSTOMER][NEUTRAL] So I have to ask them for uh uh itemized bill?
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] With the diagnostic code and then send it to you again.
[AGENT][NEUTRAL] We need, they need, OK. Yes, you will have to submit the claim again. Yes, ma'am, for review. Yes ma'am.
[CUSTOMER][POSITIVE] OK. All right. Thank you.
[AGENT][POSITIVE] OK. All right. Thank you. You're welcome. Anything else I can help you with today, Miss [PII]?
[CUSTOMER][POSITIVE] No, that's it. Have a good day. Bye-bye.
[AGENT][POSITIVE] Alright, thank you for calling