AccountId: 011433970860
ContactId: cc7315c1-2d12-48d1-b577-92163e826125
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 191759 ms
Total Talk Time (AGENT): 68279 ms
Total Talk Time (CUSTOMER): 67141 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/04/cc7315c1-2d12-48d1-b577-92163e826125_20250604T18:19_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Uh, hi, [PII]. Uh, my name is [PII] calling from doctor's office, and I'm checking on the claim denial.
[AGENT][NEUTRAL] Sure, I can assist you with that. Could you provide me with the spelling of your name and a good callback number just in case the call is disconnected?
[CUSTOMER][NEUTRAL] Yeah, sure. My uh name is spelled as [PII], and my callback number will be [PII], and this is my direct line.
[AGENT][NEUTRAL] Thank you so. Could you give me the pro provide me with the policy number, the number that you're calling in regards to the claim.
[CUSTOMER][NEUTRAL] Uh yes, the policy number for the member is 02618004.
[AGENT][NEUTRAL] Could you verify that patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, the patient's name is uh [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] And what is the date of service that you call and check the status of a claim for?
[CUSTOMER][NEUTRAL] Yes, the date of service is [PII] and uh the bill amount on this claim is $169 even.
[AGENT][NEUTRAL] This claim was received [PII]. It was processed [PII].
[AGENT][NEUTRAL] There was no payment made on this claim and the reason why there was no payment because the services provided are not covered under the policy for the member's policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And may I know what type of policy is this?
[AGENT][NEUTRAL] This is a medical limited hospital indemnity policy.
[CUSTOMER][NEUTRAL] OK. Thank you for that. And uh may I have the bill filing limit?
[AGENT][NEGATIVE] There's no timely filing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And may I have the mailing address for submitting an appeal?
[AGENT][NEUTRAL] The mailing address to submit an appeal will be addressed to American public life.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] that's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII], [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, it's [PII] is the ZIP code, right?
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][POSITIVE] OK. Thank you very much for that. And may I have the reference number for this call?
[AGENT][NEUTRAL] We don't provide those, however, you can feel free to use my name in today's date as a reference is [PII] and today's date.
[CUSTOMER][POSITIVE] Got it. So thank you very much for that information, [PII], and you have a great day.
[AGENT][POSITIVE] Thanks for calling APL. You have a great one as well, [PII]. Good bye.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.