AccountId: 011433970860
ContactId: e0da580e-c62f-4730-8eee-52fc4c683784
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 258410 ms
Total Talk Time (AGENT): 91892 ms
Total Talk Time (CUSTOMER): 81089 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/15/e0da580e-c62f-4730-8eee-52fc4c683784_20250115T18:38_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. I submitted a claim and um I saw a response towards asking for a diagnosis code, but I don't know how to send that back to you. Can I give it to you over the phone?
[AGENT][NEUTRAL] May I have the policy number and your name, please?
[CUSTOMER][NEUTRAL] My name is [PII] 250265-1.
[AGENT][NEUTRAL] And I do need to verify your date of birth and the mailing address listed on file.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] And may I have a callback number just in case this call is disconnected?
[CUSTOMER][NEUTRAL] Yes, ma'am. [PII].
[AGENT][NEUTRAL] And is this going for you or someone else listed on the policy?
[CUSTOMER][NEUTRAL] For my children.
[AGENT][NEUTRAL] Is it more than one claim or just one dependent?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Mm, uh, two different, uh, dependents.
[AGENT][NEUTRAL] OK, may I have both their names to pull those claims up?
[CUSTOMER][NEUTRAL] Yes, [PII] saw that [PII], and then my son [PII], [PII].
[CUSTOMER][NEUTRAL] Can you give me just one second, please? I'm sorry.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes, I'm here.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK. So I see for [PII] that claim did denied for the diagnosis code. So the only way that it can be received is either it will have to be in writing and submitted via fax, mail, or the secured portal.
[CUSTOMER][NEUTRAL] OK, so I have to like type up a document to send it to you?
[AGENT][NEUTRAL] It would
[CUSTOMER][NEUTRAL] And then I can submit that to the.
[AGENT][NEUTRAL] Normally we only accept it if it has the provider's letterhead, if you received it from the provider, but you can get that EOB or whatever information that you've previously submitted in and you can type it on there or write it on there and submit that same documentation back.
[CUSTOMER][NEUTRAL] Oh, OK. And so I should redo.
[CUSTOMER][NEUTRAL] Everything then resubmit everything.
[AGENT][NEUTRAL] Yes, as long as the diagnosis code is listed on there. Now, I see we haven't processed Orlando's yet.
[CUSTOMER][NEUTRAL] Yeah, I figured they're gonna tell me the same thing though, cause it's from the same office. Um, I don't know, maybe I'm wrong. Maybe I should wait to see what that finishes saying.
[AGENT][NEUTRAL] Let me look at the images that we received because actually that image is 53 pages.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, I just see that we received EBs for this image as well. So diagnosis code will have to be submitted for this member as well.
[CUSTOMER][POSITIVE] OK, so I'll go ahead and add it to those and resubmit it and see what happens. Thank you for your time I appreciate it.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Now I do want to inform you now if it's for different dates of service, it's gonna have to indicate those dates of services.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much. I appreciate.
[AGENT][POSITIVE] You're welcome. Thank you for calling American Public Life. Have a great day.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][POSITIVE] Thank you.