AccountId: 011433970860
ContactId: 1103149d-bbbd-42ac-9536-7265c58f568c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 260140 ms
Total Talk Time (AGENT): 74034 ms
Total Talk Time (CUSTOMER): 52681 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/1103149d-bbbd-42ac-9536-7265c58f568c_20250124T19:48_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from provider's office checking on claim status. Could you please help me with that?
[AGENT][POSITIVE] Yeah, absolutely. I'm happy to check on a claim for you today, [PII]. Do you have the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah. It's 02462881.
[AGENT][NEUTRAL] All right, thank you for that. Let me pull that up here. And do you have a good callback number?
[CUSTOMER][NEUTRAL] Yeah, it's [PII] to direct line.
[AGENT][NEUTRAL] Thank you. What's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. And the date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you, data service?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] [PII]. And the bill amount?
[CUSTOMER][NEUTRAL] $184 even.
[AGENT][NEUTRAL] All right, thank you. One moment, let me take a look.
[AGENT][NEUTRAL] Right. So it looks like we did receive this claim. Uh, it looks like the claim was received on one moment.
[AGENT][NEUTRAL] Claim is received on [PII].
[AGENT][NEUTRAL] Uh, the claim was denied. Office visits are not covered under the member's policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] May I know when it was denied?
[AGENT][NEUTRAL] Claim was denied on [PII].
[CUSTOMER][NEUTRAL] May I know which type of plan does have?
[AGENT][NEUTRAL] Uh, we are the secondary insurance. This is a meddling plan.
[CUSTOMER][NEUTRAL] May I know the timely filing limit?
[AGENT][NEUTRAL] No, timely filing.
[CUSTOMER][NEUTRAL] We can submit an appeal anytime.
[AGENT][NEUTRAL] Appeals have to be submitted within 180 days of the decision.
[CUSTOMER][POSITIVE] Thank you. Could you please spell out your name?
[AGENT][NEUTRAL] My name is spelled [PII].
[CUSTOMER][NEUTRAL] Thank you. May I know the call reference?
[AGENT][NEUTRAL] Call reference is my name with my last initial and today's date. The last initial to my name is [PII].
[CUSTOMER][POSITIVE] Thank you. Thank you for providing this information. That's all for today. Have a good day.
[AGENT][NEUTRAL] You too. Bye bye.
[CUSTOMER][NEUTRAL] Bye.