AccountId: 011433970860
ContactId: bcd196ea-d34f-4a77-97df-84ef24e1861b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 534989 ms
Total Talk Time (AGENT): 175436 ms
Total Talk Time (CUSTOMER): 144134 ms
Interruptions: 3
Overall Sentiment: AGENT=-0.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/bcd196ea-d34f-4a77-97df-84ef24e1861b_20250429T12:28_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi [PII], um, good morning. My name is [PII]. I just had a question regarding, um, like a claim that was processed. Maybe you can help me.
[AGENT][NEUTRAL] So you want to know the status of a claim?
[CUSTOMER][NEGATIVE] No, I know the status of the claim. I just don't understand what they're asking for.
[AGENT][NEUTRAL] What's the policy? What's the policy?
[CUSTOMER][NEUTRAL] They're asking for info.
[AGENT][NEUTRAL] What's the policy number?
[CUSTOMER][NEUTRAL] Um, the policy number is 248.
[CUSTOMER][NEUTRAL] 984 9
[AGENT][NEUTRAL] And is it, you, are you the provider or the insured?
[CUSTOMER][NEUTRAL] The insured.
[AGENT][NEUTRAL] Can I have your callback number, mailing address, and your date of birth?
[CUSTOMER][NEUTRAL] A callback is [PII]. My name is [PII]. My date of birth is [PII], and my home address is [PII].
[AGENT][NEUTRAL] Thank you and what is the claim number that you're calling in regards to?
[CUSTOMER][NEUTRAL] It says 3594599.
[AGENT][NEUTRAL] So they're requesting information from your physician from the provider where you receive the services of the diagnosis, so you need to contact them to request the itemized bill.
[CUSTOMER][NEUTRAL] Well, the bill that I provided does provide the um description of the service and the CPT code.
[AGENT][NEUTRAL] That's the CPTs those are not the.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Huh.
[AGENT][NEUTRAL] Let me look it up.
[CUSTOMER][NEUTRAL] It has a CPT code.
[AGENT][NEUTRAL] That's the CPT code, but not an ICD code. An ICD 10 code and the CPT code are two different codes.
[CUSTOMER][NEUTRAL] What is the other code you're saying? ICV?
[AGENT][NEUTRAL] Uh IC ICD 10 is a diagnosis code, the reason for the visit.
[AGENT][NEGATIVE] Not the procedures that's being performed.
[CUSTOMER][NEUTRAL] OK, so it's
[CUSTOMER][NEUTRAL] Let me just write this down. So I like igloo, C like Charlie.
[CUSTOMER][NEUTRAL] D like David.
[AGENT][NEUTRAL] D as in dog, yes, 10 codes.
[CUSTOMER][NEUTRAL] ICD dash 10 codes.
[AGENT][NEUTRAL] Which is diagnosis.
[CUSTOMER][NEUTRAL] OK. And this is something they would provide, right?
[AGENT][NEUTRAL] Yeah, you just request the itemized bill. Tell them that your insurance company is requesting an itemized bill.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. All right. I'll call them today. All right, thank you. Do you, uh, by any chance?
[AGENT][NEUTRAL] Alright, is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] Uh, yes, it's really quick, um, or maybe you don't know. What is the, um, do you know what I would be eligible for if I were to get it approved?
[AGENT][NEUTRAL] Um, no, cause this is not a.
[CUSTOMER][NEUTRAL] Or does that go by each code?
[AGENT][NEUTRAL] This is not a product that I work on. Actually you're calling a different queue, but I could just look at it and help you the best that I can, but I can transfer you to that queue so you can ask them and they may can assist you with that issue, that question.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] But I definitely can't.
[CUSTOMER][POSITIVE] OK, that would be great if you don't mind, thank you.
[AGENT][NEUTRAL] Hold one moment.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[AGENT][NEUTRAL] Hey [PII], how are you doing?
[CUSTOMER][NEUTRAL] I'm well how are you?
[AGENT][NEUTRAL] Oh, and I'm great, thanks for asking. I don't think that you're gonna be able to assist this insurer because she wants to know.
[AGENT][NEUTRAL] How much her claim would get paid once she sent in to request the documentation for HI claim.
[CUSTOMER][NEUTRAL] Yeah, no one will be able to answer that until they process it.
[AGENT][NEUTRAL] OK, so I'll let her know.
[CUSTOMER][NEUTRAL] I can tell you what the benefits are for like a particular.
[CUSTOMER][NEUTRAL] If she, I could say the benefits, but like for guarantee we can't guarantee.
[AGENT][NEUTRAL] I don't even know what it is that she went for. Let me give you the policy number so you can look at the claim.
[CUSTOMER][NEUTRAL] OK, well, 1st may I have your name and a good contact number in case we're disconnected?
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] So, I'm [PII] and claims.
[AGENT][NEUTRAL] Meddling claims department.
[CUSTOMER][NEUTRAL] Oh, you're, you're us.
[AGENT][NEUTRAL] Yes. I, I'm not sure if it shows up.
[CUSTOMER][NEUTRAL] Oh, I thought you were a provider.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Sorry.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, what's her policy number? I'm sorry, I thought you were a provider.
[AGENT][NEUTRAL] It
[AGENT][NEUTRAL] Uh oh, you're fine it's 248-9849. That's why I was like, I don't think you're gonna be able to assist her with it because I know you work in customer um.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Here.
[AGENT][NEUTRAL] She need an adjuster.
[CUSTOMER][NEUTRAL] OK. And then, um,
[AGENT][NEUTRAL] And the claim is
[AGENT][NEUTRAL] It's the very first one on part two.
[CUSTOMER][NEUTRAL] Hold on, it's coming up.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Part two.
[AGENT][NEGATIVE] Cause I know these policies are very limited, but I don't even know what benefit this is that they even use to process the claim.
[AGENT][NEUTRAL] Mm, I'm here.
[AGENT][NEGATIVE] The phone call hung up.
[AGENT][NEUTRAL] Could you hear me?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hi.
[AGENT][NEUTRAL] Um, Ms. [PII], I'm trying to get someone to, I'm trying to reach out to someone to better assist you. However, I'm not being able to reach out to anyone at the moment.
[CUSTOMER][NEUTRAL] I've been on hold?
[AGENT][NEUTRAL] Can someone give you a call back?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yeah, that would be great.
[AGENT][NEUTRAL] Alright, um, your callback number is [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Alright, so someone will give you a call back in regards to your questions about your benefits.
[CUSTOMER][POSITIVE] OK, great. Thank you for your help.
[AGENT][POSITIVE] Thanks for calling APL and have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.