AccountId: 011433970860
ContactId: 14da0d87-ce1d-49fb-925a-ae69d8990bac
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 221119 ms
Total Talk Time (AGENT): 80896 ms
Total Talk Time (CUSTOMER): 81105 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/17/14da0d87-ce1d-49fb-925a-ae69d8990bac_20250617T13:48_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, my name is [PII] calling for Pur office to check on denial claim clarification. And please be noted, this call is being recorded, monitored for the quality training purposes.
[AGENT][POSITIVE] All right, I'm happy to check on a claim. Do we have the policy number, claim number?
[CUSTOMER][NEUTRAL] Yeah, I do have a policy number and that's going to be 02198577 M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] And do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. May I have the patient name and date of birth?
[CUSTOMER][NEUTRAL] Oh yeah, sure. One moment.
[CUSTOMER][NEUTRAL] Patient name is going to be [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] And the policy number, let me read this back, it was 02.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] 198517.
[CUSTOMER][NEUTRAL] No, no, 77.
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] And then what's the date of service?
[CUSTOMER][NEUTRAL] Date of service is going to be [PII].
[AGENT][NEUTRAL] In the adult amount.
[CUSTOMER][NEUTRAL] OK one moment.
[CUSTOMER][NEUTRAL] Bill amount is, just give me a second.
[CUSTOMER][NEUTRAL] $135 even.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] So the claim was received on [PII]. Claim was denied on [PII].
[AGENT][NEUTRAL] Office visits are not covered under the member's policy.
[CUSTOMER][NEUTRAL] OK, one moment. Office visits are not covered as per the member's policy, am I right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] May I have an appealing mailing address?
[AGENT][NEUTRAL] That would be [PII].
[AGENT][NEUTRAL] That's in [PII].
[CUSTOMER][NEUTRAL] Can you spell the word after [PII]?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And then
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then [PII] again, which is [PII]
[CUSTOMER][NEUTRAL] [PII]. OK. [PII], right?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] May I have a timely filing limit for appeal?
[AGENT][NEUTRAL] 180 days from the decision.
[CUSTOMER][NEUTRAL] Uh, may I have the dinner date again?
[AGENT][NEUTRAL] That was on [PII].
[CUSTOMER][NEUTRAL] May I have the claim number?
[AGENT][NEUTRAL] 3606448
[CUSTOMER][NEUTRAL] 48. And may I also have a call reference number?
[AGENT][NEUTRAL] That would be my name with today's date.
[CUSTOMER][POSITIVE] OK, thank you so much and have a great day bye bye bye.
[AGENT][NEUTRAL] You