AccountId: 011433970860
ContactId: b6c1f54a-0493-4dfe-85d1-6ed8efa291f4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 380119 ms
Total Talk Time (AGENT): 125403 ms
Total Talk Time (CUSTOMER): 71257 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/26/b6c1f54a-0493-4dfe-85d1-6ed8efa291f4_20250226T13:53_UTC.wav
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[AGENT][NEUTRAL] APL this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, I'm [PII]. I'm calling from Pro office to the correct claim status.
[AGENT][NEUTRAL] OK, I can help you. Can you spell your first name, please?
[CUSTOMER][NEUTRAL] Sure. My name is [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Is it [PII]?
[AGENT][NEUTRAL] AH OK. And what's the policy number?
[CUSTOMER][NEUTRAL] 023 06682
[AGENT][NEUTRAL] And what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII] is the extension.
[AGENT][NEUTRAL] OK, I'm gonna repeat what you just said. I have a phone number of [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And the extension again, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. And if you can verify the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. You said [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and you said that you're checking for a claim status?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, if you can provide the date of service in charge, please.
[CUSTOMER][NEUTRAL] [PII] and charges $542 542 dollars.
[AGENT][NEUTRAL] OK, could you repeat the date of service for me again?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. OK, thank you.
[AGENT][NEUTRAL] And [PII], is this for an office visit charge?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So I'm showing the claim was received [PII].
[AGENT][NEUTRAL] Processed [PII].
[AGENT][NEUTRAL] Um, office visits are not covered by this policy, so there was no payment made.
[AGENT][NEUTRAL] And I'm showing it processed under claim number 349.
[AGENT][NEUTRAL] 391 8.
[AGENT][NEUTRAL] And [PII], you can also check your status online at [PII]. And did you have any other questions that I could help out with today?
[CUSTOMER][NEUTRAL] Give me one moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, the office was it either?
[AGENT][NEUTRAL] I'm here.
[CUSTOMER][NEUTRAL] The office visits are not covered under which plan, patient plan or provider plan?
[AGENT][NEUTRAL] It's gonna be the patient's policy.
[CUSTOMER][NEUTRAL] OK. Can I get the app details?
[AGENT][NEUTRAL] And so the appeal time frame is 180 days from the date of denial.
[CUSTOMER][NEUTRAL] OK. What's the dinner date then?
[AGENT][NEUTRAL] The date that it was processed on [PII].
[CUSTOMER][NEUTRAL] OK. Give me the apple fax number.
[AGENT][NEUTRAL] 877-365.
[AGENT][NEUTRAL] 942-3 attention appeals.
[CUSTOMER][NEUTRAL] OK. Give me one moment.
[CUSTOMER][NEUTRAL] OK. What's the mailing address?
[AGENT][NEUTRAL] It's the same as the claims mailing address [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Is this the first level of?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Is this the first level of a pill?
[AGENT][NEUTRAL] I'm not sure is this the first time this date of service was appealed?
[CUSTOMER][NEUTRAL] OK. When was the claim received actually?
[AGENT][NEUTRAL] On [PII].
[CUSTOMER][NEUTRAL] OK. 1 I.
[CUSTOMER][NEUTRAL] OK, can I get your name and call reference?
[AGENT][NEUTRAL] You'll use my name in today's date as reference for today's call [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] First initial and last name is [PII]. And did you have any other questions I can help out with today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, thanks for today. Have uh have you, uh, hope you have a good day. Bye for now. Thank you.
[AGENT][POSITIVE] You too, [PII]. Thanks for calling APL. Have a good day.