AccountId: 011433970860
ContactId: ab598b5c-417a-4570-95b6-55253a38c063
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 269820 ms
Total Talk Time (AGENT): 116568 ms
Total Talk Time (CUSTOMER): 140708 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/ab598b5c-417a-4570-95b6-55253a38c063_20250204T15:32_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, hi there. This is [PII]. I'm calling for the provider, uh [PII]. Please note this call will be monitored and recorded for quality and training purposes. I'm calling for the clarification on the appeals on the deny claim.
[AGENT][NEUTRAL] OK, I can check on an appeal for you. uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]. No extension.
[AGENT][NEUTRAL] OK, thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Uh yes. It's 01851927 M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] OK, thank you. And what was the name and date of birth for the insured?
[CUSTOMER][NEGATIVE] OK you don't get.
[CUSTOMER][NEUTRAL] The first name is [PII], last name is [PII]. Date of birth, [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that [PII]. All right, and let's take a look here. When was that, uh, appeal submitted to us?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, [PII] by mail. The mailing address [PII], OK, [PII] or the CPT code [PII].
[CUSTOMER][NEUTRAL] Hello
[AGENT][NEUTRAL] OK, and what was the original claim number?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] The claim number is um um just a moment.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yes, it's uh 351-453-6.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, one moment please. I don't think we've received that appeal, [PII]. The last thing I'm showing we received for this number was that original claim. I'm not showing that we received anything past that.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK, sir.
[CUSTOMER][NEUTRAL] So I not on file, right? You have not received any app bill.
[AGENT][POSITIVE] Correct. That's correct.
[CUSTOMER][NEUTRAL] So this is the correct address for the appeal as we discussed.
[AGENT][NEUTRAL] Yes, uh, [PII]. I've also got a, uh, fax number if you'd like, [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][POSITIVE] Yes, please go ahead.
[AGENT][NEUTRAL] OK it is 877.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] All right. Attention is the appeals.
[AGENT][NEUTRAL] Uh, it, uh, claims department is fine.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Claim department, perfect. And time limit for the appeal?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Appeals timely filing limit are 180 days from the process date and let me verify that.
[AGENT][NEUTRAL] So that was [PII] for when we received this original claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh get the claim time filing limit just for my accommodation purpose.
[AGENT][NEUTRAL] What was that? I'm sorry.
[CUSTOMER][NEUTRAL] Correct the claim timely filing limit.
[AGENT][NEUTRAL] It was 180 days.
[CUSTOMER][NEUTRAL] Uh, correct the claim also 10 days from the proceeded. All right. And, uh, correct the claim mailing address is the same as for the address.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] It is the same. Yes, sir.
[CUSTOMER][POSITIVE] Perfect, perfect. And is there any specific appeal from you?
[AGENT][NEUTRAL] No, um, all we would really need is of course whatever corrected information that you have and then we would need a letter uh of course stating that it is an appeal and why.
[CUSTOMER][NEUTRAL] Mhm, mhm.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] All right. So there is no any specific appeal from you, right?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] And we need to attend dinnerOB.
[AGENT][NEUTRAL] Uh, say it again, I'm sorry.
[CUSTOMER][NEUTRAL] We need to attend denied EOB explanation of benefit.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] All right. Call reference number?
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date. Uh so my name is spelled [PII] was there anything else I could help you with, [PII]?
[CUSTOMER][POSITIVE] Thank you so.
[CUSTOMER][POSITIVE] Uh, no, I, thank you so much for assisting me. Have a great day. Bye for now.
[AGENT][POSITIVE] OK, yeah, thanks for calling APL you too bye bye.