AccountId: 011433970860
ContactId: cf83857d-19f4-4c70-8df1-a9032d7efb94
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 387799 ms
Total Talk Time (AGENT): 151665 ms
Total Talk Time (CUSTOMER): 143176 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/cf83857d-19f4-4c70-8df1-a9032d7efb94_20250624T15:06_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII]. Um, my policy number is 2569536.
[AGENT][NEUTRAL] OK. Can you verify your date of birth for me, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is your address and email address?
[CUSTOMER][NEUTRAL] Address is [PII] and my email address is [PII].
[AGENT][NEUTRAL] OK, thank you and then do you have a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][POSITIVE] OK. How can I help you today?
[CUSTOMER][NEUTRAL] Um, I was, I put in a few claims recently and I have some more to put in, um, but I just wanted to see if you could check the ones I put in if I, uh, included everything correctly, um, before I move forward with the rest and, um, how long they take to process and basically what the whole um process looks like as far as submitting claims.
[AGENT][NEUTRAL] OK, uh, let me see. OK, it looks like we did recently receive some for is this for yourself?
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Uh, I believe I put 1 for myself and 2 for my spouse.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, let's see
[AGENT][NEUTRAL] OK, the one for yourself. Let me pull that up.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, from Quest Diagnostics.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, it looks like from [PII] for 3-1306.
[AGENT][NEUTRAL] Um, let's see, so for that one.
[AGENT][NEUTRAL] Diagnosis is. I don't see a
[AGENT][NEUTRAL] OK, we've got the explanation of benefits. We have the bill, which shows your
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Looks like the only thing missing is your diagnosis code. I don't see. I see the, what procedures were rendered.
[AGENT][NEUTRAL] Um, cause it looks like on the, the quest diagnostic bill, it does show us.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] CPT codes, but there's also ICD 10 codes that we need, um, which represent the diagnosis.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] I'm not seeing those on the.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That's what we're missing, yeah.
[CUSTOMER][NEUTRAL] Um, so that
[CUSTOMER][NEUTRAL] So that that needs to be on the quest bill.
[AGENT][NEUTRAL] Correct. I don't know if maybe they have a portal um that you can log into that might have that information.
[AGENT][NEUTRAL] Um, or sometimes it, sometimes it does, sometimes it doesn't. It just depends on the provider, um, but the diagnosis codes is what we need and the, and the documentation has to come from the provider. You can't just take it like verbally and write it in.
[CUSTOMER][NEUTRAL] Diagnosis.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Yeah, and, and they're called um ICD 10, so I as in India, C as in Charlie, D as in Delta, 10, yep.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] ICD 10 code OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, OK, so they do they need like.
[CUSTOMER][NEUTRAL] Do I need another bill or they can just send me the code?
[CUSTOMER][NEUTRAL] Like on a letters like what what exactly do I need to tell them?
[AGENT][NEUTRAL] But
[AGENT][NEUTRAL] Yeah, if I mean if they can send you documentation of that it can come by form of letter or by form of the actual claim, um, the actual claim will include all of the information sometimes they're more which a claim is called a CMS 1500, um, so C as in Charlie, M as in Mary, S as in Sam, 1500 is the actual claim form that they fill out all of the information on.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You might mention those things. Sometimes it
[CUSTOMER][NEUTRAL] CMF 1500.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, alright, so I'll contact them for that. So then, um.
[CUSTOMER][NEUTRAL] Uh, I have some other, um.
[CUSTOMER][NEUTRAL] Some other claims I need to put in but not from Quest. I need to reach out to, uh, you know, other doctors, so it's the same thing. I'm gonna need the bill. I'm gonna need the explanation of benefits and I'm gonna need the ICD 10 basically.
[AGENT][NEUTRAL] Correct, yeah, and like I said.
[CUSTOMER][NEUTRAL] For any claim.
[AGENT][NEUTRAL] Yes, yeah, anything going forward and once we receive that information, the processing time takes up to 7 working days and then and then it should be processed so.
[CUSTOMER][NEUTRAL] OK, so, uh, once I get the ones for the claims I already submitted, how do I kind of like attach it to those to those claims? How would I submit it again?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] You'll, you'll have to go onto the portal and then just, you'll have to start a new claim and then just just upload that.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I'll start a new claim.
[AGENT][NEUTRAL] Yeah, we'll, we'll be able to match it to what we've received, so.
[CUSTOMER][POSITIVE] OK, alright, thank you.
[AGENT][POSITIVE] OK, thanks for calling [PII]. I hope you have a good day.
[CUSTOMER][NEUTRAL] You too. Bye.