AccountId: 011433970860
ContactId: cc642536-d49f-4178-bda7-c405a2c220d9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 585450 ms
Total Talk Time (AGENT): 197611 ms
Total Talk Time (CUSTOMER): 152598 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/cc642536-d49f-4178-bda7-c405a2c220d9_20250620T18:48_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling AP. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from provider office looking for a claim appease status.
[AGENT][NEUTRAL] Uh, you said an appeal?
[CUSTOMER][NEUTRAL] Yes, claims appeal status.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Sure I can check on that for you. I'm sorry what that your name was?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] Could you spell that for me please?
[CUSTOMER][NEUTRAL] 732.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK thank you would you mind spelling your name for me please?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Last name [PII].
[AGENT][NEUTRAL] OK, thank you, and then do you have that policy number?
[CUSTOMER][NEUTRAL] Yes, the member policy number is.
[CUSTOMER][NEUTRAL] 018.
[CUSTOMER][NEUTRAL] 13065
[CUSTOMER][NEUTRAL] M as in Mary, L as in
[CUSTOMER][POSITIVE] Love it.
[AGENT][NEUTRAL] OK, thank you and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] First name is [PII], last name [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. um, what was the claim that this was appeal was in regard to?
[CUSTOMER][NEUTRAL] Data service is.
[CUSTOMER][NEUTRAL] [PII] bill amount $624.
[AGENT][NEUTRAL] OK, the date of service you said that was [PII]?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] [PII] for $624.
[CUSTOMER][NEUTRAL] Right, and appeal was submitted on [PII] through fax.
[AGENT][NEUTRAL] OK, one moment, let me take a look.
[AGENT][NEUTRAL] Do you have the uh tax ID for this provider?
[CUSTOMER][NEUTRAL] Yes, 35.
[CUSTOMER][NEUTRAL] 244.
[CUSTOMER][NEUTRAL] 2399.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And just to confirm, you did say that total bill amount was $624 is that correct?
[CUSTOMER][POSITIVE] Yes, it's correct.
[AGENT][POSITIVE] OK, OK, thank you one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] I do believe I found where that had been reprocessed.
[AGENT][NEUTRAL] For 3 procedure codes, it looks like we did pay a benefit of $78.50.
[AGENT][NEUTRAL] If you'd like I can fax this information over to you.
[CUSTOMER][NEUTRAL] OK. The CPTJ 9035 was denied previously because insurers need primary EOB and we submit appeal. You said the claim was refunded, right?
[AGENT][NEUTRAL] Right, that that's what we paid on J 9035, yes, we paid that benefit of $78.51.
[CUSTOMER][POSITIVE] Thank you. May I have
[CUSTOMER][NEUTRAL] Check number for this claim.
[AGENT][NEUTRAL] Yes, and I will say it's also um an updated uh claim number as well if you needed that. The check number is 2045784.
[CUSTOMER][NEUTRAL] And claim numbers?
[AGENT][NEUTRAL] 36.
[AGENT][NEUTRAL] 037777.
[CUSTOMER][NEUTRAL] Thank you. And when they paid this claim?
[CUSTOMER][NEUTRAL] Check date.
[AGENT][NEUTRAL] Yes, that was issued on [PII], and I am showing this check did clear [PII].
[CUSTOMER][NEUTRAL] Maybe [PII], right?
[AGENT][POSITIVE] Correct, yes, [PII].
[CUSTOMER][NEUTRAL] Thank you. uh, can you fax the information?
[CUSTOMER][NEUTRAL] Copy of EOB.
[AGENT][NEUTRAL] Uh yes.
[AGENT][NEUTRAL] Sure, what was that fax number for you?
[CUSTOMER][NEUTRAL] 305.
[CUSTOMER][NEUTRAL] 928.
[CUSTOMER][NEUTRAL] 6742. This is our fax number and attention my name, [PII] and last name, [PII].
[AGENT][NEUTRAL] OK, I'm gonna read that fax number back to make sure I heard that correctly. That was [PII].
[CUSTOMER][POSITIVE] Yes, that is correct.
[AGENT][POSITIVE] OK, I'll go ahead and send that now. You should get it within about 10 minutes or so. Was there anything else I could help you with?
[CUSTOMER][NEUTRAL] Uh, may I have reference for this call?
[AGENT][NEUTRAL] Uh, reference number would be my first name, last initial, and today's date. Uh, so my name is spelled [PII] last initial [PII]
[CUSTOMER][NEUTRAL] That
[CUSTOMER][POSITIVE] Thank you. I have one more claim for this member.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] OK, one moment please.
[CUSTOMER][NEUTRAL] Last
[CUSTOMER][POSITIVE] OK good thank you.
[AGENT][NEUTRAL] OK, it's another claim for the same member?
[CUSTOMER][NEUTRAL] Same number but different data server and we submit appeal.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, what was that date of service please?
[CUSTOMER][NEUTRAL] [PII] and bill amount $652 even.
[AGENT][NEUTRAL] 652.
[CUSTOMER][NEUTRAL] 5652
[AGENT][NEUTRAL] OK, and this was with the same provider correct?
[CUSTOMER][NEUTRAL] Yes, same provider.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it looks like, uh, is that the same procedure code, the J 9035?
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, yes, so we paid on this one as well, um, that was also $78.51 and I've got that claim and check number for you whenever you're ready.
[CUSTOMER][POSITIVE] I am ready.
[AGENT][NEUTRAL] OK, claim number is 3603.
[AGENT][NEUTRAL] 769.
[CUSTOMER][NEUTRAL] Claim number.
[AGENT][NEUTRAL] That was the claim number.
[CUSTOMER][NEUTRAL] And check numbers.
[AGENT][NEUTRAL] Check number is 2045783.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Check claim uh check date.
[AGENT][NEUTRAL] Yes, this one was also issued on [PII] and also cleared on [PII].
[CUSTOMER][NEUTRAL] Check date is [PII], right?
[AGENT][NEUTRAL] Uh, that was when it was, uh, cleared, yes.
[CUSTOMER][NEUTRAL] Can you fax this copy of your bill?
[AGENT][POSITIVE] Oh sure, I'll go ahead and get that one sent to you as well.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] OK, so I sent that one as well you should be getting that shortly. Was there anything else I can help you with?
[CUSTOMER][POSITIVE] No, thank you so much for assisting me today. Have a nice day. Thank you, [PII].
[AGENT][NEUTRAL] Of course.
[AGENT][POSITIVE] Yeah, thanks for calling APL you too thank you bye bye.
[CUSTOMER][POSITIVE] Thank you