AccountId: 011433970860
ContactId: 89b246bf-535c-412a-ae4e-25e04724c31a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 359059 ms
Total Talk Time (AGENT): 133043 ms
Total Talk Time (CUSTOMER): 133321 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/89b246bf-535c-412a-ae4e-25e04724c31a_20250110T18:01_UTC.wav
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[AGENT][POSITIVE] Good afternoon thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh hi, [PII], sir. My name is [PII] calling from provider's office to check the status on uh appeal. Could you please help me with that?
[AGENT][POSITIVE] It would be my pleasure to assist you, ma'am. Do you mind spelling your name for documentation?
[CUSTOMER][NEUTRAL] Uh, [PII] and last initial is [PII].
[AGENT][POSITIVE] Thank you, [PII], and what is a good callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] 018.
[CUSTOMER][NEUTRAL] 68895.
[AGENT][NEUTRAL] Thank you, [PII]. And [PII], what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] patient name is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is her date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] All right, thank you. Now, is this a recent appeal or is it a previous appeal?
[CUSTOMER][NEUTRAL] Uh, most recent on [PII]. It was sent on [PII], a month ago.
[AGENT][NEUTRAL] On [PII].
[AGENT][NEUTRAL] I don't have an appeal on file let me.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Let me hang on just a second, it may be under another policy. Let me check because this policy turned on [PII]. What was the date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], let me check.
[AGENT][NEUTRAL] For Isabel.
[CUSTOMER][NEUTRAL] Uh, actually, uh, actually, uh, we already received a payment from APL of uh 2500.
[CUSTOMER][NEUTRAL] Uh, $50.
[AGENT][NEUTRAL] Do you happen to have that claim number?
[CUSTOMER][NEUTRAL] Yeah, I do have.
[AGENT][NEUTRAL] And what is the claim number?
[CUSTOMER][NEUTRAL] Yeah, sure. It's uh
[CUSTOMER][NEUTRAL] patient number and claim number.
[CUSTOMER][NEUTRAL] Uh looking along. Claim number is 333.
[CUSTOMER][NEUTRAL] 9261.
[AGENT][NEUTRAL] Now was this on an appeal?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] But you said you sent it in on 12-2424?
[CUSTOMER][NEUTRAL] Uh yes, uh, 12 9 24.
[AGENT][NEUTRAL] 12 9 24.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I don't have a an appeal on file.
[AGENT][NEUTRAL] From [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] And do you know where that was sent?
[CUSTOMER][NEUTRAL] Uh, let me check the address.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Sorry
[AGENT][NEUTRAL] OK, that's fine.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm. Address.
[AGENT][NEUTRAL] And what, what date was the appeal for?
[CUSTOMER][NEUTRAL] Uh, for, uh, emergency room under the bed?
[AGENT][NEUTRAL] For 7
[CUSTOMER][NEUTRAL] Uh yes, I found the uh address.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It is uh [PII]
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEGATIVE] That is the incorrect address.
[AGENT][NEUTRAL] That address is no longer valid for claim submission.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Uh, for appeal permission, right? Or claim.
[AGENT][NEUTRAL] Yeah, for.
[AGENT][NEUTRAL] For appeals you would need to send it to a different address. In fact, that [PII] is no longer a valid claim submission address.
[CUSTOMER][NEUTRAL] Both
[CUSTOMER][NEUTRAL] Provide me the correct one, please.
[AGENT][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Ok [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Thank you. And uh could you please spell your name for me, then call reference number?
[AGENT][NEUTRAL] My name is [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] First initial of my last name is [PII] and the reference number is my name and today's date.
[CUSTOMER][POSITIVE] OK, [PII]. Thank you. Have a great uh happy weekend. Bye-bye.
[AGENT][POSITIVE] I hope you have a happy weekend as well, [PII]. It was a pleasure to assist you with that appeal status and thank you for calling APL. Take care.
[CUSTOMER][POSITIVE] Thank you so much. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.