AccountId: 011433970860
ContactId: 81ec4b89-4278-4886-9710-891e25b2c3cb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 354359 ms
Total Talk Time (AGENT): 120579 ms
Total Talk Time (CUSTOMER): 111045 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/2025/06/18/81ec4b89-4278-4886-9710-891e25b2c3cb_20250618T19:53_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi this is [PII] from um University Hospital Medical Group. How are you today?
[AGENT][POSITIVE] Good, how are you?
[CUSTOMER][NEUTRAL] I'm good. I was calling to to see where I can um send um these this claim appeals that I have in my office. Um, would you guys want it from like to through fax or by email?
[AGENT][NEUTRAL] Um, you can send it through fax or through the mail. Our fax number is, it will be attention appeals department.
[AGENT][NEUTRAL] And it's [PII], are you ready?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, hold one second. I was actually in the middle of doing it while I was ringing for a phone call. Hold on one second.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Um, you said yeah.
[CUSTOMER][NEUTRAL] And what's the fax number?
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] 365
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK, so while I have you on the phone, is it OK if you uh.
[CUSTOMER][NEUTRAL] Are you able to look up the claim for me?
[AGENT][NEUTRAL] I'm sorry, could you repeat?
[CUSTOMER][NEUTRAL] Well, I know that it needs to be peeled, but.
[CUSTOMER][NEUTRAL] I said I know it needs to be appealed already um so it's, it's up to you if you have the time to look for, um, look up a claim if you can't, that's fine too.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, sorry, I wasn't able to hear you. um.
[AGENT][NEUTRAL] What's a good callback number in case we get disconnected? Yeah, it's just, you just sound a little bit far away, but that's OK. I can hear you um.
[CUSTOMER][NEUTRAL] Are you able to hear me now?
[CUSTOMER][NEUTRAL] Oh, I'm sorry, it's [PII].
[CUSTOMER][NEUTRAL] 286
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what's the policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The policy number is 02566961.
[AGENT][NEUTRAL] OK, give me just a moment and I can look that up.
[AGENT][NEUTRAL] Can you verify the patient's name and date of birth for me, please?
[CUSTOMER][NEUTRAL] Sure, [PII], that's the first name.
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] OK and um do you have the claim number on file?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] What's that sorry.
[CUSTOMER][NEUTRAL] It is 3606793.
[AGENT][NEUTRAL] OK give me just a moment.
[AGENT][NEUTRAL] OK, yes, I see we um.
[AGENT][NEUTRAL] Processed that on [PII]. Proceed on [PII].
[AGENT][NEUTRAL] Excuse me.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So you still just need the.
[CUSTOMER][NEUTRAL] You still need the information from us, right?
[AGENT][NEUTRAL] Um, so let me see.
[AGENT][NEUTRAL] It looks like that date of service is after her coverage dropped with us um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, it looks like her policy it has an effective date of [PII]. It was processed on January or I'm sorry.
[AGENT][NEUTRAL] Her policy has an effective date of [PII] and the policy lapsed on [PII].
[AGENT][NEUTRAL] And she does not have any other policies active with us.
[CUSTOMER][NEUTRAL] So she wasn't covered.
[CUSTOMER][NEUTRAL] For this
[AGENT][NEUTRAL] Right, so when the claim got denied it was because the date of service was after uh she lost coverage.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So what was the last date? I'm sorry, can you repeat that for me?
[AGENT][NEUTRAL] Uh, yes, the policy termed on July, I'm sorry, I apologize. The policy termed on [PII].
[CUSTOMER][NEUTRAL] It's OK.
[CUSTOMER][NEUTRAL] Oh [PII].
[CUSTOMER][NEGATIVE] And uh that's I got it. What's no point of me sending you this information anyhow because it wasn't covered.
[CUSTOMER][POSITIVE] All right, well that works. Thanks so much. What was your name?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else I can help you with? Um, my name is [PII], last initial [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, you want me to use this as a reference?
[AGENT][NEUTRAL] Um, you can, we don't have reference numbers. We don't have reference numbers. You just use my name and last initial in today's date.
[CUSTOMER][NEUTRAL] For the cost.
[CUSTOMER][POSITIVE] Got it. OK, thanks so much, [PII]. Have a good day.
[AGENT][POSITIVE] OK thank you for calling APL. I hope you have a great week.
[CUSTOMER][NEUTRAL] You too.