AccountId: 011433970860
ContactId: 40a9dc6b-dc7d-4262-afcc-4662d6b02b2e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 286619 ms
Total Talk Time (AGENT): 59154 ms
Total Talk Time (CUSTOMER): 103436 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/40a9dc6b-dc7d-4262-afcc-4662d6b02b2e_20250610T14:57_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office. You're gonna claim status.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, uh, [PII], just a moment.
[CUSTOMER][NEUTRAL] Yes, uh, the callback number is [PII] and it's a direct line and there is no any extension.
[AGENT][NEUTRAL] OK, and you have the policy number for the patient?
[CUSTOMER][NEUTRAL] Just a moment, the fish.
[CUSTOMER][NEUTRAL] OK, the policy number is 02334237.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] The patient name is [PII].
[AGENT][NEUTRAL] Uh, date of birth?
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] And date of service and bill charges?
[CUSTOMER][NEUTRAL] Just a moment, [PII].
[CUSTOMER][NEUTRAL] of sorts.
[CUSTOMER][NEUTRAL] Yes, the rate of service is 12/16 of 2024 and the bill amount is $7,69 even.
[AGENT][NEUTRAL] OK, give me one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, claim was received on 3-31-2025.
[AGENT][NEUTRAL] Process 324, 2025.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, outpatient benefit for the calendar year has been met, dollar amount.
[CUSTOMER][NEUTRAL] OK, that's been processed towards deductable step that you are saying.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] This claim has been processed towards deductible, right?
[AGENT][NEGATIVE] No, we've denied it because the outpatient calendar, your maximum was meant.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Calendar year has been maximum has been me, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, that means you're like saying it's a unit or visits?
[AGENT][NEUTRAL] Dollar amount.
[CUSTOMER][NEUTRAL] OK, $1 a month. OK. Can you tell me what is the dollar amount and how many has been got taxes?
[AGENT][NEUTRAL] The dollar amount is $6650.
[CUSTOMER][NEUTRAL] So 6:50, OK.
[AGENT][NEUTRAL] What was the other question?
[CUSTOMER][NEUTRAL] And the med test?
[CUSTOMER][NEUTRAL] OK, the met is uh 6650, right?
[AGENT][NEUTRAL] Sorry.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. Can you provide me the appeal mailing address?
[AGENT][NEUTRAL] Uh, [PII] mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm. Mhm.
[CUSTOMER][NEUTRAL] After that order this?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK, then the time limit it's gonna be?
[AGENT][NEUTRAL] 180 days from process date.
[CUSTOMER][NEUTRAL] I don't know. He just stick.
[CUSTOMER][NEUTRAL] OK. What will be the call reference number? It's gonna be [PII].
[AGENT][NEUTRAL] [PII], and today's date.
[CUSTOMER][NEUTRAL] OK, [PII].
[CUSTOMER][POSITIVE] OK, [PII]. Thank you for the information that you have been provided to me. Have a wonderful day and take care and stay safe. Bye-bye.