AccountId: 011433970860
ContactId: 119c4987-593c-447c-99d4-caa8467b74a6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 377489 ms
Total Talk Time (AGENT): 121056 ms
Total Talk Time (CUSTOMER): 142876 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/18/119c4987-593c-447c-99d4-caa8467b74a6_20250418T16:06_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, hi [PII]. My name is [PII]. I'm calling from Providers office to check on Apple status. Could you please help me with that today?
[AGENT][NEUTRAL] OK, you're calling to check on.
[CUSTOMER][NEUTRAL] Apples.
[AGENT][NEUTRAL] An appeal?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and spell your name for me?
[CUSTOMER][NEUTRAL] Sure, my name is [PII]. That is [PII] and my last name is [PII].
[AGENT][NEUTRAL] OK, you're talking really fast. Did you say your name is [PII]?
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] OK, and what's the policy number?
[CUSTOMER][NEUTRAL] It's um
[CUSTOMER][NEUTRAL] 2662731
[AGENT][NEUTRAL] And your phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]. Extension is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And are you calling on behalf of the provider's office?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And what's the name of the provider's office?
[CUSTOMER][NEUTRAL] It's uh Radiology Association of Northern Kentucky.
[AGENT][NEUTRAL] OK. What's the patient? You gave me 2662731?
[CUSTOMER][NEUTRAL] 2662731, yes.
[AGENT][NEUTRAL] OK, I'm not pulling anything up under that number. Do you have a copy of the card?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh, actually, we speak one of the representative, they provide me the claim status also for this one. So I'm just requesting you that please check with that patient's name and date of birth.
[AGENT][NEUTRAL] OK, spell the patient's first and last name slowly, please.
[CUSTOMER][NEUTRAL] It's [PII]. Last name is [PII].
[AGENT][POSITIVE] Thank you one moment.
[AGENT][NEUTRAL] And what type of claim is it? Is it a medical claim or a dental claim?
[CUSTOMER][NEUTRAL] Medical.
[AGENT][NEUTRAL] The policy number is 2462731.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the date of birth of the patient?
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] It's uh [PII].
[AGENT][NEUTRAL] And what's the date of service of the claim, please?
[CUSTOMER][NEUTRAL] It's uh [PII], with the total charge of $314 even.
[AGENT][NEUTRAL] And the total bill?
[AGENT][NEUTRAL] OK, and what is it that you are appealing?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] One second.
[CUSTOMER][NEUTRAL] And uh we submitted this appeal on [PII].
[AGENT][NEUTRAL] Is this for a CT scan?
[CUSTOMER][NEUTRAL] City, yes.
[AGENT][NEUTRAL] OK, can you verify the address the appeal was mailed to?
[CUSTOMER][NEUTRAL] the
[CUSTOMER][NEUTRAL] Yeah, sure. Uh, one second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, mm, come on, one minute actually for this one we submitted through the fax number that is a [PII].
[AGENT][NEUTRAL] OK, so the fax number for American Public Life is 877.
[AGENT][NEUTRAL] 365.
[AGENT][NEGATIVE] 942-3 attention claims and I don't show that we've received it appears that fax number you sent it to was the incorrect one.
[CUSTOMER][NEUTRAL] OK, one second. Give me a minute.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] One moment, let me document this.
[CUSTOMER][NEUTRAL] Could you please help me with your mailing address?
[AGENT][NEUTRAL] It's the same as the claim's mailing address. What address do you have for the claims mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so the is that where you mailed it to?
[CUSTOMER][NEUTRAL] Uh yes.
[AGENT][NEUTRAL] OK, so the PO box to submit the pill is [PII].
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] 248.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] 950.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Um-hum.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Of course
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I just
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] 4
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] [PII] is the zip code zip code.
[CUSTOMER][NEUTRAL] Mm OK.
[CUSTOMER][NEUTRAL] Oh [PII]
[CUSTOMER][NEUTRAL] Can you find any limit to submit this?
[AGENT][NEUTRAL] It's 180 days from the date of the denial of the decision.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK. Call reference number?
[AGENT][NEUTRAL] You'll use my name in today's date as your reference [PII].
[AGENT][NEUTRAL] ONYA first initial of my last name is [PII], did you have any other questions we can help out with today?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Thanks. No, [PII], thank you for the information and you have a wonderful day. Thank you. Bye-bye.
[AGENT][NEUTRAL] Uh, you're welcome, and ma'am, you'll need to make that to the attention of appeals in order for it to be reviewed by the appeals uh area.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Yeah, sure, definitely.
[AGENT][NEUTRAL] All [PII]. Anything else?
[CUSTOMER][NEUTRAL] He
[CUSTOMER][POSITIVE] No thank you, thank you for the information. Have a great day bye bye.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. Have a good day.