AccountId: 011433970860
ContactId: 561592e6-1033-41e0-8c62-3104e3d5406e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 444989 ms
Total Talk Time (AGENT): 118676 ms
Total Talk Time (CUSTOMER): 111888 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/22/561592e6-1033-41e0-8c62-3104e3d5406e_20250122T15:20_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 Prada's office to check on the status. Could you please assist?
[AGENT][NEUTRAL] I'm sorry, uh, claim status?
[CUSTOMER][NEUTRAL] It's for the claim appeals, yes.
[AGENT][NEUTRAL] Yeah, I could check on a claim for you um and what did you say your name was?
[CUSTOMER][NEUTRAL] It's [PII] Last name is [PII].
[AGENT][NEUTRAL] OK, and [PII], can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] Sure, my callback number is [PII] with my extension [PII].
[AGENT][NEUTRAL] OK, thank you and then do you have the policy number?
[CUSTOMER][NEUTRAL] Sure. And the policy number is 02510205.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] The patient's name is [PII] with the date of birth of [PII].
[AGENT][NEUTRAL] Alright, thank you for verifying that [PII] and what was the date of service for this claim?
[CUSTOMER][NEUTRAL] The date of service is at 10/14 of $2024 for the total charge of $35 even. And for this we have submitted an appeal on [PII].
[AGENT][NEUTRAL] OK, so we're checking on the appeal.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Got it. OK, thank you one moment.
[AGENT][POSITIVE] Bear with me just a moment, [PII]. I appreciate your patience.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][POSITIVE] Yes, I'm so sorry. I did find the response letter bear with me just a moment to see what that response was.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so I, I, I'm so sorry for the wait, [PII]. I do appreciate your patience. um, so the response letter did state that the denied service code is correct.
[AGENT][NEUTRAL] I said that this claim was originally processed correctly?
[CUSTOMER][NEUTRAL] OK. Could you
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] And so no benefits are payable.
[CUSTOMER][NEUTRAL] OK, so could you please send me the recipient of this Apila joint?
[AGENT][POSITIVE] Yes, and I'll be uh happy to send this to you as well let's see.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So we did receive this on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it was processed [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So the bill has been approved because there is uh it is denied as non-culture and as providers plan, is that right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Would you like me to send this to you? I can fax you the letter.
[CUSTOMER][NEUTRAL] Just a moment to document this.
[CUSTOMER][NEUTRAL] Sure, just a moment for that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Thank you. So could you please provide me with the document control number, case number for this?
[AGENT][NEUTRAL] Could you repeat that? I'm sorry.
[CUSTOMER][NEUTRAL] Could you please provide me with the document control number or a case number for this?
[AGENT][NEUTRAL] Absolutely it is 3541558.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Thank you. So could you please send the claim number as well?
[AGENT][NEUTRAL] Oh, that is the claim number.
[CUSTOMER][NEUTRAL] Um, so could you please tell me the document control number or the apple ticket number for this?
[AGENT][NEUTRAL] That it's just um let's see, I believe that's gonna be the only identification letter or number that we have for this appeal.
[CUSTOMER][NEUTRAL] OK, I have a different claim number here for this uh denied claim here, so could you please tell me what the claim number this is about?
[AGENT][NEUTRAL] Oh, do you mean the original claim? I'm sorry.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] Yeah go ahead you can give me that I'll confirm that that's correct.
[CUSTOMER][NEUTRAL] It's 352-381-8.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, yes, that is the correct original claim number.
[CUSTOMER][NEUTRAL] OK, so just to confirm, are you guys processed with the claim number in Chile, and when we submit an appeal you guys process a different claim number, is that right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, so there is no uh document control number, case number, or the ticket number for this appeal, is that right also?
[AGENT][NEUTRAL] No, it's just given a separate claim number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so could you please spell out your name for me?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Thank you. So could you please me the call reference number for a conversation?
[AGENT][NEUTRAL] Yeah, reference number would just be my first name, last initial, and today's date. Uh so my last initial is A. Was there anything else I could help you with, [PII]?
[CUSTOMER][POSITIVE] OK then thank you
[CUSTOMER][POSITIVE] No, this will be thank you so much for asking have a wonderful rest of your day.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yeah, thanks for calling APL you too bye bye.
[CUSTOMER][POSITIVE] Thank you so much bye bye.