AccountId: 011433970860
ContactId: c8394422-d392-48af-85c7-9e1a57911795
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 406850 ms
Total Talk Time (AGENT): 100134 ms
Total Talk Time (CUSTOMER): 129256 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/2025/01/15/c8394422-d392-48af-85c7-9e1a57911795_20250115T13:56_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. This is [PII], and I'm calling from Porter's office to check on the claim status and how are you today?
[AGENT][POSITIVE] I'm doing good, [PII]. How about you?
[CUSTOMER][NEUTRAL] Because
[CUSTOMER][POSITIVE] Yes, I'm pretty much good. Thanks for asking. And you said your name is [PII]?
[AGENT][NEUTRAL] Uh, [PII], first initial last name is [PII]. And what's the policy number, [PII]?
[CUSTOMER][NEUTRAL] Tonia, T uh one moment. T O N Y A, right?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sorry, uh, what are you asking about?
[AGENT][NEUTRAL] Policy number?
[CUSTOMER][NEUTRAL] Sure, Member ID policy number 02550342.
[AGENT][NEUTRAL] I get phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII] direct line.
[AGENT][NEUTRAL] OK, and can you hear me OK?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the patients, the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Go
[CUSTOMER][NEUTRAL] Sure. First name is [PII] Last name is [PII], [PII] is the date of birth for the patient.
[AGENT][NEUTRAL] OK, and what's the date of service?
[CUSTOMER][NEUTRAL] A date of service I'm looking for.
[CUSTOMER][NEUTRAL] It's [PII] $1280 even 1280.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] Oh most welcome.
[AGENT][NEUTRAL] All right, so.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] I show that this claim was received [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And I show it was processed on [PII].
[AGENT][NEGATIVE] And no payment was made on this um claim.
[AGENT][NEUTRAL] And that's because the
[CUSTOMER][POSITIVE] OK, that's been delightful.
[AGENT][NEUTRAL] The benefit maximum for this state of service has been met.
[CUSTOMER][NEUTRAL] OK, but upon checking on my end, I couldn't find any other claim on the same date of service as well as and um
[AGENT][NEUTRAL] It's from a different provider. It's from a different provider.
[AGENT][NEUTRAL] For the same date of service.
[CUSTOMER][NEUTRAL] Yes, OK.
[CUSTOMER][NEUTRAL] But I couldn't find any other claim. OK.
[CUSTOMER][NEUTRAL] One second.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Do you have any other questions?
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Uh, do you have the, uh, claim number for the, uh, claim which was paid?
[AGENT][NEUTRAL] Mhm, the claim number, it's it I'm sorry?
[CUSTOMER][NEUTRAL] The claim number which the claim was paid?
[AGENT][NEUTRAL] Yeah, but we can't disclose that because it's not your claim, we can only speak to you regarding your claim.
[CUSTOMER][NEUTRAL] On the same data service?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK, can I get the claim number now?
[AGENT][NEUTRAL] The claim number is 3533.
[AGENT][NEUTRAL] 867
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] 353-386-7 is the claim number.
[CUSTOMER][NEUTRAL] OK, got it. Could you find the mailing address, the relation mailing address?
[AGENT][NEUTRAL] What's the address on your claim?
[CUSTOMER][NEUTRAL] Address on the claim.
[AGENT][NEUTRAL] Mhm, the billing address on your claim?
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yes, it is [PII] City, [PII], right?
[AGENT][NEUTRAL] OK, so are you asking for APL's mailing address or the address that the ELB was mailed to?
[CUSTOMER][POSITIVE] No problem. I'm asking about the reconstruction mailing address or the mailing address.
[AGENT][NEUTRAL] Are you saying reconsideration?
[AGENT][NEUTRAL] Email mail, OK, it's that's the correct mailing address to APL.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] And the time funding limit for the reciation.
[AGENT][NEUTRAL] And when you say reconsideration, or do you mean appeal?
[CUSTOMER][NEUTRAL] Yes, appeal mailing, I mean appeal timing final limit.
[AGENT][NEUTRAL] It's
[AGENT][NEUTRAL] It's 180 days from the date the claim was processed.
[CUSTOMER][NEUTRAL] Can I get the reference number please?
[AGENT][NEUTRAL] My name and today's date and any other questions, [PII], I can help with today?
[CUSTOMER][POSITIVE] Uh, no, [PII]. Uh, thank you for your assistance. Have a great day. Be safe. Thank you. Bye bye. Happy.
[AGENT][POSITIVE] You're welcome. Thanks for thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Bye bye.