AccountId: 011433970860
ContactId: 761dddab-05e9-4d94-9b02-fce435d00ea4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 303929 ms
Total Talk Time (AGENT): 112215 ms
Total Talk Time (CUSTOMER): 91064 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/04/761dddab-05e9-4d94-9b02-fce435d00ea4_20250404T18:51_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]. My name is [PII], and I'm calling from Brownsville Hospital for appeal status.
[AGENT][POSITIVE] OK, [PII], I'm happy to check on an appeal for you today. Do you have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, that's 01868783.
[AGENT][NEUTRAL] Thank you for that, [PII], and then do you have a good callback number just in case if we're disconnected?
[CUSTOMER][NEUTRAL] Yes, direct line, it's [PII].
[AGENT][NEUTRAL] Thank you. What's the patient name and date of birth?
[CUSTOMER][NEUTRAL] This is for [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. So.
[AGENT][NEUTRAL] Was the appeal for date of service [PII]?
[CUSTOMER][NEUTRAL] Yes, [PII]. Yes. It's the date range.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so it looks like the appeal was received. It shows the date of [PII].
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Looks like the appeal was processed then on [PII].
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] OK, so it looks like the decision on the original claim was upheld.
[CUSTOMER][NEUTRAL] Uphel. OK, hold on. Do you have like a DCN or a document control number or case number?
[AGENT][NEUTRAL] Um, let's see.
[AGENT][NEUTRAL] That would be 356-812-4.
[CUSTOMER][NEUTRAL] 24 alright and you said it was upheld um now can we still send a next level for appeal?
[CUSTOMER][NEUTRAL] For an outpatient, I mean out of network provider.
[AGENT][NEUTRAL] Um, I don't believe that there's any, um, additional appeal status. Like once the decision is upheld, um, there are no further steps that can be taken on it.
[CUSTOMER][NEUTRAL] OK. So this is the final level. All right. Uh, just put that in here. OK. Um, now, um, can you forward the copy of that letter or decision to our business fax number?
[AGENT][NEUTRAL] Uh, yeah, absolutely. So what's the fax number?
[CUSTOMER][NEUTRAL] Yes, that would be [PII]. And please put the attention to the appeals department.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Department and then just to confirm, I had [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. Uh, I will send that. It should be there in about 5 minutes. Is there anything else I can check on for you today?
[CUSTOMER][NEUTRAL] There's no just the reference for the call.
[AGENT][NEUTRAL] Uh, call references my name with my last initial than today's date. My name again is [PII], that's [PII] and my last initial is going to be [PII].
[CUSTOMER][POSITIVE] OK, thank you so much, sir. Have a great day.
[AGENT][NEUTRAL] You too bye bye.
[CUSTOMER][NEUTRAL] Bye now.