AccountId: 011433970860
ContactId: 65d98903-eedd-4123-9044-636d768f3667
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 464640 ms
Total Talk Time (AGENT): 103790 ms
Total Talk Time (CUSTOMER): 203442 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/65d98903-eedd-4123-9044-636d768f3667_20250610T14:15_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] I'm sorry, I didn't get you. What's your name?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, it's definitely, my name is [PII] and last initial is [PII].
[CUSTOMER][NEUTRAL] Have
[AGENT][POSITIVE] OK, sure. Uh, how can I help you today?
[CUSTOMER][NEUTRAL] I just, I'm look I'm just looking the app billee status on this claim. Could you please help me with that?
[AGENT][POSITIVE] Yes, I can help with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And do you have a policy number for the patient?
[CUSTOMER][NEUTRAL] 01845704 M as in Mary, L as in Linda, number 8.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth [PII].
[CUSTOMER][NEUTRAL] Well.
[AGENT][NEUTRAL] And date of service and bill charges?
[CUSTOMER][NEUTRAL] [PII] and total bill amount, $4,0006.
[AGENT][NEUTRAL] Uh, 9:13, what year?
[CUSTOMER][NEUTRAL] 2023.
[AGENT][NEUTRAL] 2
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] OK, and what you said 4,0006, is that right?
[CUSTOMER][NEUTRAL] Yes, it's 4006.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] It looks like we received it 3 times. Let me find the one that's not a duplicate.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't know uh.
[AGENT][NEUTRAL] OK, looks like we received it on.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 1011 2023.
[AGENT][NEUTRAL] Process [PII] 2023.
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] What's
[AGENT][NEUTRAL] Outpatient benefit for calendar year wasn't met.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] It's [PII], I'm really sorry. I'm, I'm looking at the status on this. Could you please go slow for me?
[AGENT][NEUTRAL] Uh, yes, we received it on
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh that's [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Outpatient dollar amount was met?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] For the policy.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] And as per my screen as I can see, we have submitted the appeal [PII] and I'm just asking to the status of this appeal. Could you please confirm me what the status of this appeal?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Can you check?
[CUSTOMER][NEUTRAL] I think the payment.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] I'm pulling it up. Just give me a moment.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh, it is
[AGENT][NEUTRAL] Uh, we didn't receive an appeal. We just received the claim and the primary EOB again.
[AGENT][NEGATIVE] That was denied as a duplicative.
[CUSTOMER][NEUTRAL] Mm, OK. Um.
[AGENT][NEUTRAL] Received 62.
[CUSTOMER][NEUTRAL] The address
[AGENT][NEUTRAL] And process 65 and
[CUSTOMER][NEUTRAL] The address is
[CUSTOMER][NEUTRAL] [PII]. Is this the correct address?
[AGENT][NEUTRAL] No, it's not.
[AGENT][NEUTRAL] That's [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII], [PII].
[CUSTOMER][NEUTRAL] Could you please spell it for me?
[AGENT][NEUTRAL] OK [PII]
[CUSTOMER][NEUTRAL] So the next.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], [PII], and the zip code is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, as for your confirmation, you didn't receive the bill yet, right?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That's great. What's the TFL for that? May I know that?
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] Was the TFL?
[CUSTOMER][NEUTRAL] For the appeal.
[AGENT][NEUTRAL] The timely filing limit.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] 180 days from the original process date.
[CUSTOMER][NEUTRAL] 180 days.
[AGENT][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, it's been done from my side.
[CUSTOMER][NEUTRAL] [PII], could you please uh provide me the call reference number before the a ping call.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] The reference number is my name and today's date.
[CUSTOMER][NEUTRAL] Like.
[CUSTOMER][NEUTRAL] 98.
[AGENT][NEUTRAL] My name is [PII] and today's date.
[CUSTOMER][POSITIVE] OK, OK, 7 has been done from my side. Thank you very much. Have a great day. Bye-bye.
[AGENT][POSITIVE] Thanks for calling APL. You too. Bye bye.
[CUSTOMER][NEUTRAL] In