AccountId: 011433970860
ContactId: 6a0c43c8-b54b-4eb5-85ad-44cd7150b5bd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 273269 ms
Total Talk Time (AGENT): 86880 ms
Total Talk Time (CUSTOMER): 78402 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/6a0c43c8-b54b-4eb5-85ad-44cd7150b5bd_20250108T18:02_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].
[CUSTOMER][NEUTRAL] This is [PII] and I'm calling on behalf of provider office.
[CUSTOMER][NEUTRAL] Tenant Florida Physician Services LLC to check on additional information about a claim that has been denied. Please know this call will be recording and monitoring for quality and training purposes.
[AGENT][POSITIVE] OK, [PII], I'm happy to check on a claim for you today. Do you have the patient's policy number?
[CUSTOMER][NEUTRAL] 0122154
[CUSTOMER][NEUTRAL] 9 M Mary, L Lima, number 7.
[AGENT][POSITIVE] Thank you for that. And do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII] and it's a direct line.
[AGENT][POSITIVE] Thank you so much. And then if I could have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII] and the last name is [PII] and the patient's date of birth is on [PII].
[AGENT][NEUTRAL] Thank you. What is the data service?
[CUSTOMER][NEUTRAL] It's on [PII].
[AGENT][NEUTRAL] In the bill amount?
[CUSTOMER][NEUTRAL] It's 1,
[CUSTOMER][NEUTRAL] $836 even.
[AGENT][NEUTRAL] OK, so.
[AGENT][NEUTRAL] Looks like we did receive this claim [PII]. The claim was denied. Office visits are not covered under the patient's policy.
[CUSTOMER][NEUTRAL] May I know the claim number?
[AGENT][NEUTRAL] That would be 353-9494.
[CUSTOMER][NEGATIVE] It was received on [PII] and denied on?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEGATIVE] It's denied for the reason offices is not covered under the patient policy, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Thank you so much for the information. Could you please provide me the appealing mailing address?
[AGENT][NEUTRAL] That would be [PII].
[AGENT][NEUTRAL] That's in [PII].
[AGENT][NEUTRAL] And the zip code would be [PII] Attention Appeals.
[CUSTOMER][POSITIVE] Thank you so much.
[CUSTOMER][NEUTRAL] And may I know the timely filing limit?
[AGENT][NEGATIVE] Uh, there is no timely filing limit.
[CUSTOMER][NEUTRAL] OK. For this member, could you please provide me the policy effective date and term date, please?
[AGENT][NEUTRAL] Uh, yeah, let me take a look here. One moment.
[AGENT][NEUTRAL] The effective date on this policy is [PII]. There is no termination date. Policy is still active.
[CUSTOMER][POSITIVE] Thank you so much for the information.
[AGENT][NEUTRAL] Yeah. Um, is there anything else?
[CUSTOMER][NEUTRAL] Could you please provide me the call reference, please?
[AGENT][NEUTRAL] Absolutely. Call reference is my name with my last initial and then today's date. My name again is [PII], that is spelled [PII] Last initial to my name is going to be [PII].
[CUSTOMER][POSITIVE] OK, [PII], thank you so much for your assistance.
[AGENT][POSITIVE] You're welcome, [PII]. Have a good day.
[CUSTOMER][POSITIVE] Have a good day too. Bye-bye and stay.
[AGENT][NEUTRAL] Mm, bye-bye.