AccountId: 011433970860
ContactId: b8bf475c-2a87-4522-8603-ff332f8ebb3a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 135929 ms
Total Talk Time (AGENT): 5477 ms
Total Talk Time (CUSTOMER): 102893 ms
Interruptions: 0
Overall Sentiment: AGENT=3, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/b8bf475c-2a87-4522-8603-ff332f8ebb3a_20250304T22:33_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Uh, yes, I hope so. Um, I filed a claim for an accident, um, that happened last October. My wife fell and dislocated her shoulder.
[AGENT][POSITIVE] Oh, I'm sorry.
[CUSTOMER][POSITIVE] Uh, now, thank you, uh, she's doing better, um.
[AGENT][POSITIVE] Good.
[CUSTOMER][NEUTRAL] But I turned I filed the first claim for the hospital bill and an MRI that was done shortly after the hospital.
[CUSTOMER][NEUTRAL] And I got a check.
[CUSTOMER][NEGATIVE] And it said that the MRI portion was not uh says non covered service and I called y'all yesterday and talked to a lady and turns out that the what I turned in didn't have a diagnostic code.
[CUSTOMER][NEUTRAL] And that that was why it was turned down.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I got, I got something from.
[CUSTOMER][NEUTRAL] That place today I called them and told them the problem.
[CUSTOMER][NEUTRAL] And they sent me an uh a different type of document.
[CUSTOMER][NEUTRAL] Showing what was done or itemized statement.
[CUSTOMER][NEUTRAL] And it doesn't actually say diagnostic code, but it's a column that says DX1 and a column that says DX2.
[CUSTOMER][NEUTRAL] That has a number M25.311.
[CUSTOMER][NEUTRAL] And he says that's the diagnostic codes.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] I, I wanted to check to see.
[CUSTOMER][NEUTRAL] If if that sounds right as far as you know, or do I need to get it into y'all for so for an adjuster to look at.
[CUSTOMER][NEUTRAL] To see if we can get, you know, the whatever allotted amount gets paid I think it's like 125 or something like that that might.
[CUSTOMER][NEUTRAL] They, they covered for the.
[CUSTOMER][NEUTRAL] That type of service.
[CUSTOMER][NEUTRAL] Does that DX one make any sense to you?
[CUSTOMER][NEUTRAL] Are you there?
[CUSTOMER][NEUTRAL] Hello.