AccountId: 011433970860
ContactId: ff57321e-48c4-4c79-bdf6-4abf8d2c51f8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 268239 ms
Total Talk Time (AGENT): 120702 ms
Total Talk Time (CUSTOMER): 101768 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/ff57321e-48c4-4c79-bdf6-4abf8d2c51f8_20250123T18:34_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, yes, uh, I was calling. I had put in a claim and we got, uh, a letter back this, uh, explanation of benefits, and the letter says, uh, we are in receipt of a claim form that was completed by you. However, there was no charges submitted.
[CUSTOMER][NEUTRAL] You are if you are needing to file a claim, please submit the itemized charges in order for the benefits to be considered, uh.
[CUSTOMER][NEUTRAL] Where do, where do I get that? The, the charges from the doctor's office?
[AGENT][POSITIVE] OK, first, um, I'll be more than happy to help you with your claim. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Uh, my name is [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] And my number is
[CUSTOMER][NEUTRAL] 806.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you for that. And [PII], may I have the claim number or the policy number?
[CUSTOMER][NEUTRAL] The policy number is 00483244.
[CUSTOMER][POSITIVE] And I had actually received another one on my husband as well. I just hadn't had a chance to call, but I received this one today.
[CUSTOMER][NEUTRAL] So I said I better call and find out what I gotta do.
[AGENT][NEUTRAL] OK, and I have your policy here. I just need you to verify your date of birth and the mailing address on file.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, it is uh [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. Um, so anytime it's requesting the charges, the itemized bill.
[AGENT][NEUTRAL] Or the universal bill, depend depending on the location, it's the same document, they just might call it one or the other. Um, but the itemized bill shows the diagnosis codes, the procedure codes, and then all the charges.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK, and I could I get that from the doctor's office?
[AGENT][NEUTRAL] Yes, um, so you'll just, um, give them a call and for the date of service, like, let me see, hold on one moment. This one.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so yes, like the most recent claim, that one is asking.
[AGENT][NEUTRAL] For the itemized charges. So yes, you'll just reach out to the doctor. Um, let me see, this is
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Well it doesn't list it, um.
[AGENT][NEUTRAL] Whoever the doctor was that you saw, just reach out to them, the billing department and let them know that you need the itemized bill for data service [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And, and the [PII], that one is for [PII], right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. Do you have the one, the date for, uh, for [PII]?
[AGENT][NEUTRAL] Hold on [PII], I'm sorry, wait a minute. This is for [PII]. What did you say for the second one? I'm sorry.
[CUSTOMER][NEUTRAL] Uh, [PII] is my husband, and you, and, uh, my son is [PII].
[AGENT][NEUTRAL] OK, so the one that I just went over, that's for [PII]. Um, let me see for [PII]. Hold on one second.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] It's the same reason. Um, the, the itemized bill is needed for this one is [PII] for [PII].
[CUSTOMER][NEUTRAL] Don't
[CUSTOMER][POSITIVE] OK, I will give them a call and then all I need to do is send that off to y'all.
[AGENT][NEUTRAL] Right, and then
[CUSTOMER][NEUTRAL] As soon as I get that
[AGENT][NEUTRAL] Mhm. And as soon as we receive it, we'll go ahead and continue processing and then um generate the new explanation of benefits.
[CUSTOMER][NEUTRAL] OK, and you said that it should have the codes?
[AGENT][NEUTRAL] The itemized bill, yes, it has the diagnosis codes, procedure codes, and all the charges.
[CUSTOMER][POSITIVE] OK, OK, I will definitely give them a call then. Thank you so much.
[AGENT][POSITIVE] You're very welcome. Was there anything else I could assist you with today?
[CUSTOMER][POSITIVE] No, ma'am, that is it. Thank you.
[AGENT][POSITIVE] Alright, you're welcome thanks for calling APL bye bye.
[CUSTOMER][POSITIVE] OK, thank you.