AccountId: 011433970860
ContactId: b49577fe-3806-45a9-afcc-2aa23b438c05
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 277760 ms
Total Talk Time (AGENT): 69383 ms
Total Talk Time (CUSTOMER): 173717 ms
Interruptions: 3
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/10/b49577fe-3806-45a9-afcc-2aa23b438c05_20250410T20:27_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] calling on behalf of priority's office checking the claim status.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]. It's a direct line.
[AGENT][NEUTRAL] OK, thank you. And the policy number of the patient?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The policy number is 234.
[CUSTOMER][NEUTRAL] 57
[CUSTOMER][NEUTRAL] 98.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII] and date of birth is [PII].
[AGENT][NEUTRAL] And the date of service?
[CUSTOMER][NEUTRAL] For [PII] with the total charges of $928 even.
[AGENT][NEUTRAL] OK, um, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The claim was received 10-2224. Claim was processed 10-2424.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And it was denied as not not a covered benefit under this policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] All right. And we have sent an appeal to the fax number [PII].
[AGENT][NEUTRAL] OK, um, I don't show it on file yet. You know when it was sent?
[CUSTOMER][NEUTRAL] Uh, it was on
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] OK, um, I don't show anything on file.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right. So, can we submit again the appeal? May have the time finding limits?
[AGENT][NEUTRAL] A timely filing limit for appeal is 180 days from the process date.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] So yes, you can still submit that.
[CUSTOMER][NEUTRAL] It's all right. So that's the fax number, right? [PII].
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] All right. Uh, thank you.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh let's see.
[CUSTOMER][NEUTRAL] Could you please send me a copy of your business fax number?
[AGENT][NEUTRAL] OK, what's your facts?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Um, actually, um, is that the, uh, can we bill the patient, uh, total amount?
[AGENT][NEUTRAL] OK, I'll get that faxed. It just takes a few moments.
[AGENT][NEUTRAL] Um, we don't determine patient responsibility.
[AGENT][NEUTRAL] So this is a secondary or a limited hospital plan, so we don't determine patient responsibility.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Limited hospital plan. OK. Do you have any discount or provide a PPO discount in that? No, I'm just asking any, you have any discount in that.
[AGENT][NEUTRAL] There's no PPO network.
[AGENT][NEUTRAL] So we don't, we don't require a network we're not part of a network.
[CUSTOMER][POSITIVE] Uh, all right. OK. No problem. Thank you so much for that. And may I have the, uh, uh, and the fax number is [PII]. That's the fax number.
[AGENT][NEUTRAL] OK. I'll get that faxed over. Just give me a few moments. Is there anything else I can help with today?
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] No, that's all, and thank you. May I have the call reference number?
[AGENT][NEUTRAL] A call reference number is just my name and today's date, so [PII] and today's date.
[CUSTOMER][POSITIVE] All right, thank you so much, [PII]. It's a pleasure talking to you and have a good day. Bye for now.
[AGENT][POSITIVE] Thanks for calling APL. You too. Bye.
[CUSTOMER][NEUTRAL] I don't.
[CUSTOMER][NEUTRAL] Bye.