AccountId: 011433970860
ContactId: d5fa6062-ac8e-4d16-b94e-16561e246208
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 424450 ms
Total Talk Time (AGENT): 179514 ms
Total Talk Time (CUSTOMER): 193546 ms
Interruptions: 2
Overall Sentiment: AGENT=2.1, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/02/d5fa6062-ac8e-4d16-b94e-16561e246208_20250502T15:46_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is speaking. May I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII], and I had a claim submitted that you guys needed diagnosis codes on, and I, I submitted uh paperwork that the hospital sent to me that was supposed to have diagnosis codes and I just wanted to make sure that that was what you needed and everything's being processed.
[AGENT][NEUTRAL] OK, I can verify it for you. Um, Ms. [PII], what's that policy number, please?
[CUSTOMER][NEUTRAL] Policy number is 02432937.
[AGENT][POSITIVE] OK, thank you so much. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] OK, thank you. And Ms. [PII], verify your date of birth, mailing address and email address for me, please.
[CUSTOMER][NEUTRAL] OK, [PII] mailing address is [PII] and then my email address is or do you need me to slow down or are you just reading it off?
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Oh, no, you're good. I'm just making sure we have it correct in the system. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, uh, my email address is my full name [PII] and then [PII].
[AGENT][NEUTRAL] OK, thank you so much and let me see, you say you're calling about a claim that we were needing diagnosis code. Do you happen to have the date of service or the name of the provider?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I have, I have the claim number.
[AGENT][NEUTRAL] OK, yes, ma'am. What's that claim number?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] 358-880-8
[AGENT][POSITIVE] OK, thank you so much. Give me a moment let me pull that up.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Wesley Woodlawn Hospital data services [PII] this year.
[AGENT][NEUTRAL] Let's see here.
[AGENT][NEUTRAL] OK, it looks like we received some claim information on the [PII].
[AGENT][NEUTRAL] And let me pull this up.
[CUSTOMER][NEUTRAL] Yes, I uploaded what the hospital sent me on the [PII].
[CUSTOMER][NEGATIVE] And that was supposed to have the diagnosis codes on it, but I couldn't read it, of course it just looked like a bunch of jumbled.
[AGENT][NEUTRAL] Some hieroglyphics, yeah.
[CUSTOMER][NEGATIVE] Crap to me.
[AGENT][NEUTRAL] Give me one moment, Miss [PII]. I'm trying to pull up that claim so I can view it. Give me one moment.
[CUSTOMER][NEUTRAL] Sure thing.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] And how's your Friday going so far?
[CUSTOMER][POSITIVE] Not too terribly bad.
[AGENT][POSITIVE] That's good.
[CUSTOMER][POSITIVE] It's Friday, so I'm happy about that.
[AGENT][POSITIVE] Thank goodness it's probably. Absolutely, yes, ma'am.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] It just seemed like this week was so long.
[CUSTOMER][NEUTRAL] It did, yeah, this week kind of crawled by.
[AGENT][POSITIVE] My son always gets excited for Fridays because he thinks it's donut day at the house.
[CUSTOMER][NEUTRAL] Ah.
[AGENT][POSITIVE] So yay, you go nuts.
[CUSTOMER][POSITIVE] Yeah, donuts are good.
[AGENT][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] We lost our best donut shop for a while but uh apparently the a new one's opening up on Monday and they're supposed to have the same exact recipes so.
[AGENT][POSITIVE] Yay.
[CUSTOMER][POSITIVE] Hopefully it's gonna be good donuts again so yay.
[AGENT][POSITIVE] Yay.
[AGENT][NEUTRAL] Because sometimes you get tired of Krispy Kreme, there is so sweet. It's just too sweet sometimes.
[CUSTOMER][POSITIVE] Yeah, looking forward to that.
[CUSTOMER][NEGATIVE] They are, yeah, I don't like Krispy Kreme very much.
[AGENT][NEUTRAL] Yeah. OK. Uh yes, ma'am. I'm looking at the claim information and it does not have diagnosis codes on here. It has procedure codes where it shows like an X-ray was performed and it looks like a minor surgery, uh, was performed in imaging, but it doesn't have the diagnosis stating the reason for those services. Um.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] So it still doesn't have the information you need?
[AGENT][NEUTRAL] Unfortunately, no, ma'am. Um, and sometimes you can get it uh quicker or better from the physician that, um,
[CUSTOMER][NEGATIVE] Shit.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] For some reason. But yes, ma'am. You can contact your physician if they, if you have any charges for that data service from the physician. If they can give you the billing, uh, it would, most times do have the diagnosis codes on there.
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] All right, I'll check with the physician because I mean it's coming from the hospital, but maybe the physician can help me out.
[AGENT][NEUTRAL] Oh yes ma'am, uh, the physician, um, like I said, most time I have the time to know yes ma'am, and I would say, uh, sometimes you can give the provider your information with our company as secondary and they can file the claim.
[CUSTOMER][NEGATIVE] God this is ridiculous.
[CUSTOMER][NEUTRAL] OK, I'll try that too.
[CUSTOMER][NEUTRAL] Um, alright, alright, I'll try it a couple different ways and we'll see what works.
[AGENT][POSITIVE] Yes, ma'am, because most times they will have all the information we need since they would know what the insurance company would need to process a claim. It just makes it a lot easier and less stressful for you.
[CUSTOMER][NEGATIVE] Because this is getting ridiculous.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Alrighty I will uh I'll contact the hospital and give them my, my APL card information and tell them, tell them to process the damn claim since I've already sent in the claim form.
[AGENT][NEUTRAL] Yes, ma'am. And you can just let them know that this is your secondary insurance.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And I'll also
[CUSTOMER][NEUTRAL] Yeah, yeah, yeah I will alrighty alright what what was your name?
[AGENT][NEUTRAL] Yes, ma'am. It's [PII] last initial [PII]
[CUSTOMER][POSITIVE] Alright, thank you so much for your help today, [PII]. I'm sorry.
[AGENT][POSITIVE] Uh, yeah, you're fine. Well, thank you so much for calling APM Ms. [PII], and you have a great rest of your day and weekend.
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][POSITIVE] You too, ma'am. Thank you so much.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye.