AccountId: 011433970860
ContactId: 176e4fe8-b737-40d1-a46a-c55830ed85ff
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 317510 ms
Total Talk Time (AGENT): 93658 ms
Total Talk Time (CUSTOMER): 94001 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/176e4fe8-b737-40d1-a46a-c55830ed85ff_20250620T18:26_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] calling from provider's office to check on a claim status.
[AGENT][POSITIVE] OK, [PII], I'm happy to check on a claim. Do we by chance have the patient policy number?
[CUSTOMER][NEUTRAL] Yes. It is 02517424.
[AGENT][POSITIVE] Thank you. And do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] Thank you. And what's the patient?
[CUSTOMER][NEUTRAL] Your name is [PII], right?
[AGENT][NEUTRAL] Mhm. [PII]
[CUSTOMER][NEUTRAL] Oh, [PII].
[AGENT][NEUTRAL] May I, may I have the patient name and date of birth?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, sure it is.
[CUSTOMER][NEUTRAL] [PII]. And date of birth, [PII].
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] [PII]. And total charge of $348 even.
[CUSTOMER][NEUTRAL] The
[AGENT][NEUTRAL] Showing that we did receive this claim on [PII].
[AGENT][NEUTRAL] The claim was denied on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Office visits are not covered under the member policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, can I have the claim number, please?
[AGENT][NEUTRAL] 361-152-9.
[CUSTOMER][NEUTRAL] I'm not.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, which office visit is not covered?
[AGENT][NEUTRAL] So were the secondary insurance, this uh insurance does not cover the office visit.
[CUSTOMER][NEUTRAL] OK, this insurance.
[CUSTOMER][NEUTRAL] Just a second, [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So can we uh
[CUSTOMER][NEUTRAL] Uh, can I have, uh, appeal timely filing?
[AGENT][NEUTRAL] Appeals must be filed within 180 days.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] From
[AGENT][NEUTRAL] Uh, the decision, the date of denial, correct, yeah.
[CUSTOMER][NEUTRAL] Date of dinner, right?
[CUSTOMER][NEUTRAL] Yeah, can I have a bill's fax ID fax number, please?
[AGENT][NEUTRAL] The fax number is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, to whose attention?
[AGENT][NEUTRAL] Uh, claims, all appeals must be filed in the mail.
[CUSTOMER][NEUTRAL] Appeals, apples, sorry?
[AGENT][NEUTRAL] Yes, an appeal has to be sent in the US postal mail. It cannot be faxed.
[CUSTOMER][NEUTRAL] OK. Can I have the mailing address, please?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That's in [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah, that's it for today. Can I have the call reference number please, [PII]?
[AGENT][NEUTRAL] Call references my name with today's date. My name again is [PII], last initial [PII], then today's date.
[CUSTOMER][POSITIVE] OK. Thank you so much, sir.
[AGENT][POSITIVE] You're welcome, [PII]. Have a good day.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][POSITIVE] Have a great day bye bye.