AccountId: 011433970860
ContactId: ff747e21-bd20-4ae0-91fc-7892ca59512a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 526520 ms
Total Talk Time (AGENT): 187602 ms
Total Talk Time (CUSTOMER): 221982 ms
Interruptions: 2
Overall Sentiment: AGENT=0.1, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/ff747e21-bd20-4ae0-91fc-7892ca59512a_20250207T20:48_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, hi, Ms. [PII]. My name is [PII], and I'm calling about a um claim that I did last year.
[CUSTOMER][NEUTRAL] Uh, for [PII] in May, uh, the statement was, well, I have a claim number if that'll help.
[AGENT][NEUTRAL] Uh, that'll help.
[CUSTOMER][NEUTRAL] Yes ma'am, OK.
[CUSTOMER][NEUTRAL] They were saying that they needed more information. I wanted to make sure I could still try to get the information and if it was still.
[CUSTOMER][NEUTRAL] I could see a file on it. Oh shoot.
[CUSTOMER][POSITIVE] Oh brilliant.
[CUSTOMER][NEUTRAL] The claim number is 34148.
[CUSTOMER][NEUTRAL] 73.
[AGENT][NEUTRAL] What's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Or or to verify your date of birth and your mailing address for me.
[CUSTOMER][NEUTRAL] [PII] [PII]
[AGENT][NEUTRAL] And your email address?
[CUSTOMER][NEUTRAL] Uh, no, no, I might have change it. I'm gonna try [PII].
[AGENT][NEUTRAL] I'm showing a Gmail account.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, that's what we show. Do you wanna leave it at this one?
[CUSTOMER][POSITIVE] Yes ma'am, that's correct.
[AGENT][NEUTRAL] OK, alrighty, and so you have a question regarding claim number 3414873?
[CUSTOMER][NEUTRAL] Yes ma'am, I'm getting ready to file. Well, it is please provide a diagnosis code for this date. I can, but, but I think I went to several locations. I was gonna see if it was any way you show.
[AGENT][NEUTRAL] In that question, uh huh.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] On you about to switch location of hospital so I could try to track that down.
[AGENT][NEUTRAL] I'm showing [PII] Knighton Health Systems.
[CUSTOMER][NEUTRAL] And that's the thing, they have so many locations.
[AGENT][NEUTRAL] You know, you had, it looks like an emergency room visit, so that would have been at the hospital.
[AGENT][NEUTRAL] And then you have it looks to be an office visit.
[AGENT][NEUTRAL] In [PII].
[AGENT][NEUTRAL] So that may be with the provider's office.
[CUSTOMER][NEUTRAL] OK, so the claim needs the information from the emergency visit or the, the doctor's office.
[AGENT][NEUTRAL] So it's two different dates of service, so we would need the diagnosis for each date. So there's a [PII] date of service you report it to the emergency room.
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So we would need a diagnosis for that visit.
[AGENT][NEUTRAL] And then there's a date of service of [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] It looks like it's coded as an office visit and you had some lab work and maybe an injection or something.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] In [PII] and we'll need the diagnosis code for this date of service, so two different uh diagnos unless they're related to the same thing, but we'll need the documentation showing the date of service for each.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And that's the [PII] and the [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, I am about 24 years saw him.
[CUSTOMER][POSITIVE] Oh, the time is going so safe.
[CUSTOMER][NEUTRAL] OK, so on the [PII] I think that might have been at one of the urgent care, so you said it was an office visit and some lab work and an injection.
[AGENT][NEUTRAL] Well, yes.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] OK, alright then, well Ms. [PII].
[CUSTOMER][POSITIVE] You were great. I appreciate your information there. I'll see if I can follow. Is it too late? Is it too late to file on it?
[AGENT][NEUTRAL] Right.
[AGENT][NEGATIVE] No, no, there's not a timely filing limit.
[CUSTOMER][NEUTRAL] And, and I had not met, met the maximum of uh claims yet on on for the year.
[CUSTOMER][NEUTRAL] Cause I know
[CUSTOMER][NEUTRAL] I know I do my annual, my wellness and stuff like that, but I didn't know if any of that would have affected.
[CUSTOMER][NEUTRAL] You know what I'm saying if I met my uh mac.
[AGENT][NEUTRAL] Yeah, I understand. Let me look.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So you, you, you have met your uh diagnostic um wellness benefit for [PII], but that's the only claim that I show paid for that year.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Oh, OK, so I still may be able to get reimbursed for this for these dates.
[AGENT][NEUTRAL] The ones that you're talking about, yes, because they weren't wellness it's looks like it's a medical concern.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Oh, OK, OK, great, so but if they don't, if they don't provide the diagnosis then.
[CUSTOMER][POSITIVE] Well, or if nothing was wrong, I found nothing wrong with.
[CUSTOMER][NEGATIVE] I, me myself, still can't you girl.
[AGENT][NEUTRAL] Yeah, if you, if you report it, yeah, if you report it to the emergency room, um, I'm sure there's a diagnosis.
[AGENT][NEUTRAL] For it and so what I can do, I'm gonna give you the form name to request from the um.
[CUSTOMER][NEUTRAL] I see, I.
[CUSTOMER][POSITIVE] Good.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] 4 873.
[AGENT][NEUTRAL] So this looks like it could be the hospital charge, the emergency room look like a hospital charge. So, um, when you call the billing department, ask for the UVO4 form that's an itemized bill. U as in university, B as in Bob.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Number 04.
[CUSTOMER][NEUTRAL] Got it UB 044.
[AGENT][NEUTRAL] And then for if you think it was an urgent care visit um you can ask for it's an acronym as well. It's C as in Charlie, M Mary S Sam.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] And then number 1,500 1500.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So that's the itemized bill for a service in a doctor's office.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, great.
[CUSTOMER][NEUTRAL] OK, I'll try that and send it in with my [PII] hopefully.
[AGENT][NEUTRAL] OK, and let them know that it should include the diagnosis code on those two documents, and it usually does, but you may want to just reiterate it.
[CUSTOMER][NEUTRAL] I sure will.
[CUSTOMER][POSITIVE] OK, well that's great information I sure appreciate it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, [PII], any other questions I can help out with today?
[CUSTOMER][POSITIVE] No, I think that'll get me started then so on that we'll go from there. Thank you so much.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, are you going to the isn't the Super Bowl game in in [PII] this year?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] It, it is, but uh, we're further north. We're closer to, let's see, I don't know if you're familiar with [PII] Bossier, and then [PII] Or [PII] is like a good 4 hours south of us.
[AGENT][NEUTRAL] Uh-huh, uh-huh.
[AGENT][NEUTRAL] OK, 4 hours. OK. All right.
[CUSTOMER][POSITIVE] But I do intend to kind of be in the TV if possible.
[CUSTOMER][POSITIVE] I just need the comfort of my home in the rocking chair. I think that'll be good enough for me.
[AGENT][NEUTRAL] Alright.
[AGENT][NEUTRAL] Exactly. Same here.
[AGENT][NEUTRAL] Well, my popcorn.
[CUSTOMER][POSITIVE] Thank you so much. Yeah exactly some type of n.
[AGENT][POSITIVE] All right, [PII], if no other questions, thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][NEUTRAL] Bye bye.