AccountId: 011433970860
ContactId: e1ff4239-3114-4c9d-8ef4-a2c5dc3e8a88
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 378269 ms
Total Talk Time (AGENT): 135753 ms
Total Talk Time (CUSTOMER): 133421 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/e1ff4239-3114-4c9d-8ef4-a2c5dc3e8a88_20250528T21:45_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thanks for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, yes, um.
[CUSTOMER][NEGATIVE] I called because uh um I do some claims and you guys asked me for more uh information but I send all the information I have and I don't know what kind of information you're looking for.
[AGENT][NEUTRAL] OK. Uh, what is your name and the policy number, please?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, and Mr. [PII], what is that policy number?
[CUSTOMER][NEUTRAL] Policy number is 60801.
[AGENT][NEUTRAL] No, sir, that's the payer ID number. Do you have a copy of your card in front of you?
[CUSTOMER][POSITIVE] Yeah, I do.
[AGENT][NEUTRAL] Do you see like an in-hospital or outpatient benefit cert number?
[CUSTOMER][NEUTRAL] Oh, yeah, yeah. It's 024.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 556
[CUSTOMER][NEUTRAL] 10 [PII]
[CUSTOMER][NEUTRAL] 7
[AGENT][NEUTRAL] OK thank you wait a moment.
[AGENT][NEUTRAL] And give that to me one more time. It didn't come up. Say it one more time, please.
[CUSTOMER][NEUTRAL] It's, it's 02455610 [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, and verify your date of birth, mailing address and email address, please.
[CUSTOMER][NEUTRAL] [PII] [PII].
[CUSTOMER][NEUTRAL] Uh, what else?
[AGENT][NEUTRAL] Email address?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, thank you, Mr. [PII]. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yeah, so [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and who is the claim for?
[CUSTOMER][NEUTRAL] What I have for my, for my wife.
[CUSTOMER][NEUTRAL] 1 I have for Zoe, for [PII], and 3 for Zoe, 1 for [PII], and 1 for my wife, [PII].
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] You said that 1 for [PII], 12 for [PII], 1 for [PII]?
[CUSTOMER][NEUTRAL] No, it's one for kill.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 3 for Zoe and 1 for [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And let's see.
[AGENT][NEUTRAL] OK, it looks like uh for these claims, we are needing the itemized bill with diagnosis and procedure codes and the primary insurance explanation of benefits.
[CUSTOMER][NEUTRAL] But most of them is for the emergency care.
[CUSTOMER][NEUTRAL] I can't, I can't give you any, I don't know, uh, what, what we went because, for example, [PII] is just, we, we went to get a, a blood test. And Zoe is an emergency care room in [PII] also.
[AGENT][NEUTRAL] We will still need that information in order to process the claim as secondary. Um, you may contact the medical provider.
[AGENT][NEUTRAL] And request that information or you can give them our information and let them know where you're secondary and they can file the claim, but in order to process that information is required.
[CUSTOMER][NEUTRAL] You, you, you, you mean I had to go to, to, to United Health and get information from United Health and send it to you.
[AGENT][NEUTRAL] Uh, from United Health, which your primary, you can get the EOB for that date, but we also need the billing, itemized bill that you would have to contact the provider, the facility.
[CUSTOMER][NEUTRAL] But the bill is the one I sent you.
[AGENT][NEUTRAL] Yes, sir, but it does not have information we needed to process. It does not have the diagnosis and procedure codes needed to process the claim. So that's why we're asking for the itemized bill with the diagnosis codes and the primary EOB.
[CUSTOMER][NEUTRAL] OK, um, because I, what I see here.
[CUSTOMER][NEUTRAL] Well, it's, it's.
[CUSTOMER][NEUTRAL] I don't know what else I can send you because it, it is in the emergency care room and um.
[CUSTOMER][NEUTRAL] We went because she was
[CUSTOMER][NEUTRAL] She feels bad that we went to, to, to, to check her out, but I don't know. I, I, what else I can get from the emergency care room and, and send it to you. I don't, I don't know.
[AGENT][NEUTRAL] You would have to contact the billing department and request the bill showing diagnosis codes, diagnosis codes or the reason for the visit, procedure codes, or what procedures to provide or perform. It's not on the information that was submitted. Or like I said, you can give this information to the provider, let them know where you're secondary, and they can file the claim.
[CUSTOMER][POSITIVE] OK thank you I appreciate it.
[AGENT][POSITIVE] Uh yes sir, thank you for calling APL. Have a great day.