AccountId: 011433970860
ContactId: 7f7cd5cd-d5ec-439b-94f1-1918da363e67
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 278160 ms
Total Talk Time (AGENT): 74117 ms
Total Talk Time (CUSTOMER): 101541 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/16/7f7cd5cd-d5ec-439b-94f1-1918da363e67_20250616T16:39_UTC.wav
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[AGENT][NEUTRAL] APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII], this is [PII] and I'm speaking from Piedmont Rockdale Hospital. How are you doing?
[AGENT][POSITIVE] I'm good. How can I help today, [PII]?
[CUSTOMER][NEUTRAL] Can you please help me with the status?
[AGENT][POSITIVE] I'm happy to check on a claim. Do you have a policy number for the patient?
[CUSTOMER][NEUTRAL] Yes, I do have. The policy number is 02443965.
[AGENT][NEUTRAL] And for documentation, do you have a good call back number?
[CUSTOMER][NEUTRAL] Yes, callback number is [PII].
[AGENT][NEUTRAL] Thank you. What is the patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII].
[CUSTOMER][NEUTRAL] Oh, it's [PII] and the date of birth is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] The date of service is.
[CUSTOMER][NEUTRAL] [PII] with the charge amount, $3,866.20.
[AGENT][POSITIVE] Thank you one moment.
[AGENT][NEUTRAL] OK, so it looks like we did receive a claim for the state of service claim is received [PII].
[AGENT][NEUTRAL] A claim was denied [PII].
[AGENT][NEUTRAL] The benefit maximum for the state of service has already been met.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So as uh
[CUSTOMER][NEUTRAL] The claim was paid to another facility which is Summit Radiology Services with the claim number and the amount. So we have submitted you a dispute on uh
[CUSTOMER][NEUTRAL] [PII] to reconsider the claim or send back the review again.
[CUSTOMER][NEUTRAL] So have you received any uh dispute?
[AGENT][NEUTRAL] I don't
[CUSTOMER][NEUTRAL] For the reconsideration?
[AGENT][NEUTRAL] I don't see any appeal on file. One moment.
[AGENT][NEUTRAL] I don't show anything on file for an appeal.
[CUSTOMER][NEUTRAL] It was submitted to [PII].
[AGENT][NEGATIVE] That is incorrect.
[CUSTOMER][NEUTRAL] OK. Uh, can you please help me with the correct?
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Mailing address?
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that's in [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] Uh, it's [PII], right?
[AGENT][POSITIVE] Correct. Yup.
[CUSTOMER][NEUTRAL] OK, and can you please help me with the timely filing?
[AGENT][NEUTRAL] Uh, there's no timely filing limit. Appeals, however, must be filed within 180 days of the decision.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, can you please help me with your name again and uh.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Last name in you share also the reference.
[AGENT][NEUTRAL] My name is [PII], that's [PII] Call reference is my name, with today's date. The initial to my last name is gonna be [PII].
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] Thank you so much [PII] for your time have a great day.