AccountId: 011433970860
ContactId: ccfba4da-ac4b-4638-ac04-099a2277161a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 983159 ms
Total Talk Time (AGENT): 251615 ms
Total Talk Time (CUSTOMER): 481928 ms
Interruptions: 5
Overall Sentiment: AGENT=0.2, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/02/ccfba4da-ac4b-4638-ac04-099a2277161a_20250602T20:07_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] He
[CUSTOMER][NEUTRAL] Um, yes, hello, um, I'm calling, I'm calling, um, because I submitted a claim and she said I had to, um, submit my DX code which which was the front of my discharge papers and I, I, and I did, I just wanna make sure you did receive it because my log in online. I don't see it so I just wanna make sure you did receive all of my documents.
[AGENT][NEUTRAL] OK. Do you have a phone number I can get in case we get disconnected, I can call you back?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] And do you have your policy number?
[CUSTOMER][NEUTRAL] What?
[CUSTOMER][NEUTRAL] Um, yes, it's 255-243-5.
[AGENT][NEUTRAL] Thank you. Hold on one moment, please.
[CUSTOMER][POSITIVE] Alright, no problem.
[AGENT][NEUTRAL] And what was your name?
[CUSTOMER][NEUTRAL] Um, [PII], but the claim was for spouse or somebody else on my spouse. She's also insured on my insurance. Her name would be [PII].
[AGENT][NEUTRAL] OK. And can I verify your date of birth, please?
[CUSTOMER][NEUTRAL] My date of birth is [PII].
[AGENT][NEUTRAL] And can I verify your address and email address, please?
[CUSTOMER][NEUTRAL] OK, my um address is [PII].
[CUSTOMER][NEUTRAL] Email address is [PII].
[AGENT][NEUTRAL] Thank you, Mr. [PII]. And you were wanting to check and see if we got the claim that you sent in that has your diagnosis code on it?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK. Hold on one moment. I'll check that for you.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Oh yeah.
[AGENT][NEUTRAL] And what date of service was it for?
[CUSTOMER][NEUTRAL] It was for [PII].
[AGENT][NEUTRAL] Was it for the facility bill, the hospital bill?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Yes, sir. That was paid. The hospital bill was paid and we paid $2000.
[CUSTOMER][NEUTRAL] No, well, this is for the data service, um, for 326.
[AGENT][NEUTRAL] 326 for the physician charge?
[CUSTOMER][NEUTRAL] But my dad, my dad
[AGENT][NEUTRAL] Or anesthesia.
[CUSTOMER][NEUTRAL] Yes, um, I submitted.
[CUSTOMER][NEUTRAL] No, I submitted the um EOB and itemized. I just had to attach the VS code to it.
[AGENT][NEUTRAL] OK. Was it for a facility bill or doctor's charge? Do you know?
[CUSTOMER][NEUTRAL] Actually
[CUSTOMER][NEUTRAL] Um, no, it's, it's on the itemized or, or it, it's on the itemized. I'm not sure.
[AGENT][NEUTRAL] We have an inpatient physician charge, we have the facility bill, and we have an anesthesiologist bill.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, so, um, with the automatic EMB provide you with that?
[AGENT][NEUTRAL] For
[AGENT][NEUTRAL] It looks like everything's.
[CUSTOMER][NEGATIVE] It should be on the itemized.
[AGENT][POSITIVE] Everything's been processed that we received, it was processed today.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] you
[CUSTOMER][NEUTRAL] OK. Um,
[CUSTOMER][NEUTRAL] I submitted one today.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Um, for 326.
[AGENT][NEUTRAL] And we paid 2000.
[CUSTOMER][NEGATIVE] You in jail.
[AGENT][NEUTRAL] We paid $2000 today.
[CUSTOMER][NEUTRAL] I tell you.
[CUSTOMER][NEUTRAL] You pay how much?
[AGENT][NEUTRAL] 2000
[CUSTOMER][NEUTRAL] For the data service for 326.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um, I really
[CUSTOMER][NEUTRAL] Um, how? Because I, I, I submitted, I submitted it earlier, but they said I had to submit it. Thank you. You said I submitted DS code.
[AGENT][NEUTRAL] Right, they have the DX code and they paid the claim today.
[CUSTOMER][NEUTRAL] For the data services of 326?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else I can help you with?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][POSITIVE] So, so you tell me the one I did the first time is good enough.
[AGENT][NEUTRAL] Are you still there?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes, I'm still here. Are you still there?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes, I am. I said, OK, someone, someone, someone told me that um that um the BSO that I put the first time wasn't eligible.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Um, I wrote it on, it was on the, um, the itemized bill, one of the itemized bills. So she told me to submit my discharge paper and I did that. That's why I was calling you to see, but you're telling me that um that they still processed it with the first one I did, right?
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] I guess they got the one in um that you sent in earlier did you upload it through our online service center?
[CUSTOMER][NEGATIVE] Yes, yes, I did, but, OK, maybe because the lady told me something else. OK, because she told me that that wasn't basically good enough. I had to submit a discharge paper.
[AGENT][NEUTRAL] Yes, they got, they got that one in.
[AGENT][NEUTRAL] Did you submit the discharge paper today?
[CUSTOMER][NEUTRAL] Yes, I submitted it maybe an hour after 30 minutes to 1 hour after she, she told me that um.
[AGENT][NEUTRAL] OK. Well.
[AGENT][NEUTRAL] She went ahead and processed it and paid that $2000.
[CUSTOMER][NEUTRAL] OK. And am I able to log in and see it online?
[AGENT][POSITIVE] You should be able to, yes, sir.
[CUSTOMER][NEUTRAL] OK, because earlier I didn't see it. That's why I was calling to make sure that you had everything, um, so my question is, and that's for the data service of 326, correct?
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEGATIVE] She could have just paid it before I got on the phone. I'm not sure.
[CUSTOMER][NEUTRAL] OK, maybe because I know I've got paid for one where I put the DS code on there, like the reason for the visit, but the lady was telling me something else, like I had to do a discharge paper. Um, but, um, I guess not then. Maybe she told me the wrong information. I'm guessing.
[AGENT][NEUTRAL] Uh.
[AGENT][NEUTRAL] But you said you sent the discharge paper that had the DX on it today?
[CUSTOMER][NEUTRAL] Yes, I did.
[AGENT][NEUTRAL] OK, then she's processed that what you're sending in.
[CUSTOMER][NEUTRAL] Oh, OK, um, OK, so you're saying that on your end, OK, so I'm gonna log in to see if I see it and you know, I just wanna make sure that everything is correct and I sent the correct document documents in.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] But um, OK, I guess so, so, OK, and that's what, and I have a question about one for it says the data service of 324 I mean of [PII]. Do you know which one that is because it said it was paid the amount of 2000 as well, but I didn't, I don't, I don't recall I don't recall that one, but when I logged in I've seen that.
[AGENT][NEUTRAL] Is that on
[AGENT][NEUTRAL] Who, who is that on?
[CUSTOMER][NEUTRAL] Um, I'm not sure. I, I, I believe it was on, um.
[CUSTOMER][NEUTRAL] Sorry for let me.
[AGENT][NEUTRAL] And what was the date of service?
[CUSTOMER][NEUTRAL] It says [PII].
[AGENT][NEUTRAL] I do not see a date for that data service under [PII].
[CUSTOMER][NEUTRAL] OK, it may be under um one second, I, I'm looking at it right now.
[CUSTOMER][NEUTRAL] OK, it's on the data service of
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] OK, for [PII].
[AGENT][NEUTRAL] We haven't paid on that one yet. We need the diagnosis code.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I submitted the diagnosis code for that one?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK, it says 2, 2000.
[CUSTOMER][NEUTRAL] Um, it says, sorry, it says $2000 it says amount paid and $2000. Maybe you're just waiting on the DS quote for that data service, um.
[AGENT][NEUTRAL] For that data service we're waiting on the diagnosis code.
[CUSTOMER][NEUTRAL] OK, um, am I able to look at my files? Are you able to send me the files attached because you got updated our system. It, I don't see where it let me see the files attached so I can get the correct diagnostic.
[AGENT][NEUTRAL] You should be able to see it on the online service center.
[CUSTOMER][NEUTRAL] OK, um, no, I, I actually see the claim number is 354-9281.
[AGENT][NEUTRAL] Uh.
[AGENT][NEUTRAL] Right. We need the DX code.
[CUSTOMER][NEUTRAL] And the, but I don't see.
[CUSTOMER][NEGATIVE] It says status process and it says amount paid 2000 but I don't even see it doesn't let me click where it says like do files attached.
[AGENT][NEUTRAL] Hold on just a moment.
[AGENT][NEGATIVE] And when you click on it, it won't let you open it?
[CUSTOMER][NEUTRAL] Um, there's nothing to click on. It actually has a, a circle spinning in the right top corner for all of my, um, previous, um, claims that was processed or being processed. It's like it's not fully loaded or something, but all of them have a spinning circle. I don't know is it because of your system. I know I was having problems earlier, it wouldn't let me um create my account, but then it, it started working. I created, but it's like the system is still kind of like it's loading almost.
[CUSTOMER][NEUTRAL] Oh, OK, one of them says download documents would I have the file on it?
[AGENT][NEUTRAL] It should
[CUSTOMER][NEUTRAL] OK, I click on let me see view. I pressed view.
[AGENT][NEUTRAL] Yeah, I know they were having problems with it earlier this morning.
[CUSTOMER][NEUTRAL] OK, yeah, it's not letting me do it.
[CUSTOMER][NEUTRAL] Maybe if I download it, OK, that's it oh but it says EOB so I'm pretty sure that is the files.
[AGENT][NEUTRAL] Yeah, the EOB would be, would explain what we are paying.
[CUSTOMER][NEUTRAL] Z E O V.
[CUSTOMER][NEUTRAL] OK, so, so that one is just waiting on the diagnosis so, and I don't, and I don't, I don't see the new one that you said was processed, the one that I filed today. I don't, I don't see it online. Maybe, um, the site is still, you know, malfunctioning a little bit maybe.
[AGENT][NEUTRAL] Yes. Mhm.
[AGENT][NEUTRAL] Um, the claim number for it would be 3608292.
[CUSTOMER][NEUTRAL] OK, yes, no, all my previous ones has 354-355, um, yes, uh, I have, I have no claim with that number, um, maybe.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It may take a few minutes. She could have just did it like I said right before we got on the phone. I'm, I'm not sure, but that, that's the claim number you would be looking for for that $2000.
[CUSTOMER][NEUTRAL] From 326 data service, correct?
[AGENT][NEUTRAL] Right, the 326, yes.
[CUSTOMER][NEUTRAL] OK, and what, can you repeat that claim number to me please?
[AGENT][NEUTRAL] 3608292.
[CUSTOMER][NEUTRAL] OK, sorry about that. I do see it. It just has no amount paid the amount paid says 0.
[AGENT][NEUTRAL] It may not show till tomorrow since she just did it today.
[CUSTOMER][NEUTRAL] OK, OK, I'm just trying to get an understanding of what's going on.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] So if you log in tomorrow and don't see it.
[AGENT][NEUTRAL] Then give us, give us a call back and let us look at it because it should be it's in the it should be under.
[CUSTOMER][NEUTRAL] OK, but on, but on your
[CUSTOMER][NEUTRAL] OK, but on your end you see it, correct?
[AGENT][NEUTRAL] Right, and it has to go overnight.
[AGENT][NEUTRAL] So it'd be tomorrow probably before it shows.
[CUSTOMER][NEUTRAL] OK, OK, that's fine.
[CUSTOMER][NEUTRAL] OK, that's fine.
[CUSTOMER][NEUTRAL] So that's, that's everything I guess. And is it a, OK, that's everything I guess. I wanted, I was trying to pull up the EOB for the [PII], I mean the two, the [PII] 1 but I mean it's not letting me.
[AGENT][NEUTRAL] That's claim number 354-9281.
[CUSTOMER][NEUTRAL] Maybe it was loaded.
[CUSTOMER][NEUTRAL] Um, 354 9, yes, correct, that one. So I just need the diagnosis tools for that one.
[AGENT][NEUTRAL] Yes, that's the one.
[AGENT][NEUTRAL] Right. Just the diagnosis code. Uh-huh.
[CUSTOMER][POSITIVE] OK, OK, thank you so much.
[AGENT][POSITIVE] You're welcome. Is there anything else I can help you with?
[CUSTOMER][POSITIVE] Um, no, that's everything. Thank you.
[AGENT][POSITIVE] Thank you, Mr. [PII] for calling APO. You have a good day.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] I'm so sick of this phone.
[AGENT][NEUTRAL] can pay for
[AGENT][NEUTRAL] this book out.
[AGENT][NEGATIVE] And washing machine fucking quit.