AccountId: 011433970860
ContactId: ab3e963d-8437-4089-8ad1-47922f5e4a23
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 349200 ms
Total Talk Time (AGENT): 118297 ms
Total Talk Time (CUSTOMER): 91874 ms
Interruptions: 2
Overall Sentiment: AGENT=0.2, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/ab3e963d-8437-4089-8ad1-47922f5e4a23_20250428T19:27_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Um, yes, [PII] calling in regards to a claim that I have submitted with uh the gap plan.
[AGENT][NEUTRAL] OK. May I have your name and then your policy number?
[CUSTOMER][NEUTRAL] Sure, um, my name is [PII]. Policy number is 018079974.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And [PII], could you please verify your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And may I please have a callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And I do need to verify the mailing address that is listed on file.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, and you were calling in regards to a claim. May I have the date of service or that claim number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Claim number 3589676.
[AGENT][NEUTRAL] OK, I did pull that claim up for you. How may I assist you?
[CUSTOMER][NEUTRAL] Can you tell me what the status of that claim is?
[AGENT][NEUTRAL] It is showing that it did not. It's requesting for diagnosis code from the provider.
[CUSTOMER][NEUTRAL] OK, I thought I'd already sent all that in. You don't show receiving it?
[AGENT][NEUTRAL] Let me check that for you.
[AGENT][NEUTRAL] So it looks like for the date of service of [PII].
[AGENT][NEGATIVE] When we received the claim, the first time, we denied it asking for diagnosis codes.
[AGENT][NEUTRAL] 11:27.
[AGENT][NEGATIVE] And also 4:30, they were all previously denied for diagnosis and then we received it again and there were no diagnosis code listed as well.
[CUSTOMER][NEGATIVE] Oh goodness how frustrating.
[AGENT][NEUTRAL] No, I'm gonna look up the information as well that you submitted in.
[CUSTOMER][NEGATIVE] Yeah, and I don't shame on me. I should have brought all my stuff to work with me today before I called um.
[CUSTOMER][NEUTRAL] But I had called the provider and requested the diagnosis codes and I know they sent it and I'm pretty sure I faxed it over to you um but I don't have that information in front of me so I'll have to get it when I get home and call tomorrow.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm pulling up your images as well.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, so for the claim that we received on [PII].
[AGENT][NEUTRAL] OK, so they, we do have the.
[AGENT][NEGATIVE] Itemized type bill from the provider, but this is not showing.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Diagnosis codes listed. So, if this was for a facility charge, for the diagnosis that will actually be listed on your discharge papers.
[AGENT][NEUTRAL] For those dates of service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So you got the itemized bill but it doesn't have the information on it that we need.
[AGENT][NEUTRAL] No, they will have to, you will have to ask them for an ICD 10.
[AGENT][NEUTRAL] Code
[CUSTOMER][NEUTRAL] I see.
[CUSTOMER][NEUTRAL] D 10.
[AGENT][NEUTRAL] The yes and it will have to indicate those dates of service that you're submitting in. So if it's more than one date of service, it would have to indicate that information. So we'll have to show [PII], [PII], and [PII].
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, I will call them right now then.
[AGENT][POSITIVE] OK. Is there anything else that I can assist you with today? You're welcome.
[CUSTOMER][POSITIVE] I appreciate your help, no ma'am, thank you so much.
[AGENT][POSITIVE] Thank you so much for call. You're welcome. Thank you for calling American Public Life. Have a great day. Bye.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] You too bye.