AccountId: 011433970860
ContactId: 79ff13ca-3821-4225-9ef8-f8cf72e7d3ab
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 242070 ms
Total Talk Time (AGENT): 68170 ms
Total Talk Time (CUSTOMER): 63696 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/01/79ff13ca-3821-4225-9ef8-f8cf72e7d3ab_20250401T14:51_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]. Last name initial [PII], calling on behalf of provider to check on a claim status.
[AGENT][POSITIVE] All right, [PII], I'm happy to check on a claim for you today. Can I get the patient's policy number?
[CUSTOMER][NEUTRAL] Sure. 0246 0623.
[AGENT][POSITIVE] Thank you. And do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] direct line.
[AGENT][NEUTRAL] Thank you. And patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. Data service.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] What's the data service?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Build them out.
[CUSTOMER][NEUTRAL] 5900
[CUSTOMER][NEUTRAL] $89.70.
[AGENT][NEUTRAL] One moment, please.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yes, please, and what's your last name initial?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] So we did receive a claim for the state of service claim was received on [PII].
[AGENT][NEUTRAL] Claims processed on [PII]. There was a benefit payment sent in the amount of $100 in a single check.
[CUSTOMER][NEUTRAL] Alright, actually,
[CUSTOMER][POSITIVE] Like there is no denial on the claim and as for the EOB claim has been processed correctly.
[CUSTOMER][NEUTRAL] But our expected amount is more so regarding this, we have submitted the appeal on [PII] on the mailing address. So can you please check whether you have received anything or not?
[AGENT][NEUTRAL] I do not show an appeal on file. Would you like to verify the address?
[CUSTOMER][NEUTRAL] Sure. So,
[CUSTOMER][NEUTRAL] Address is [PII].
[AGENT][POSITIVE] That is correct, yes.
[AGENT][NEGATIVE] I don't show any appeals on file, unfortunately.
[CUSTOMER][NEUTRAL] Is a timely finding limit to submit.
[AGENT][NEUTRAL] Appeals must be filed within 180 days of the decision.
[CUSTOMER][NEUTRAL] Uh, do you have any fax number to submit suit?
[AGENT][NEUTRAL] Uh, we accept claims via fax, but appeals can only be sent in the mail.
[CUSTOMER][NEUTRAL] Thank you, can you please help me with the call reference number?
[AGENT][NEUTRAL] Call reference is my name with my last initial than today's date. My name is [PII], last initial [PII] and then today's date.
[CUSTOMER][POSITIVE] Uh, that's it from us. Thanks so much. Thank you for your assistance. Have a great day.
[AGENT][NEUTRAL] You too [PII] bye bye.