AccountId: 011433970860
ContactId: db341450-51e6-4d86-9852-98c4f0dd6858
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 839450 ms
Total Talk Time (AGENT): 100279 ms
Total Talk Time (CUSTOMER): 142365 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/db341450-51e6-4d86-9852-98c4f0dd6858_20250320T20:31_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] and I'm calling you from the provider office. I just want to know the status. Can you please help me?
[AGENT][NEUTRAL] You're checking on an appeal status, is that correct, [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I'm happy to check on that. What's the patient's policy number?
[CUSTOMER][NEUTRAL] One moment, I'm telling you.
[CUSTOMER][NEUTRAL] The policy number is D as in David 454011174.
[AGENT][NEGATIVE] Unfortunately, I can't pull the patient with that number. Do you have their name or social?
[CUSTOMER][NEUTRAL] Yeah, the patient's name is, uh, the first name is [PII].
[CUSTOMER][NEUTRAL] [PII], and the last name is [PII]
[AGENT][NEUTRAL] OK. Thank you. One moment.
[AGENT][NEUTRAL] What is the patient's date of birth, please?
[CUSTOMER][NEUTRAL] Patient date of birth is uh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] Was the appeal sent for a medical claim?
[CUSTOMER][NEUTRAL] OK, so I just want to know, uh, actually I do not have the UOB of this claim also, so I just want to ask you what is the status of it is first of all, tell me the status of it is.
[AGENT][NEUTRAL] OK, what's the date of service?
[CUSTOMER][NEUTRAL] Date of service is [PII] with bill the amount $4,438.10.
[AGENT][NEUTRAL] OK. Let me take a look for the claim. Give me one moment, please.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And what is your name? Can you spell out your name, please?
[AGENT][NEUTRAL] My name is [PII], that is spelled [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And what is your last name, [PII]?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're welcome. One moment.
[AGENT][NEUTRAL] OK, so it looks like we did get a claim for the state of service. Uh, the claim was denied. The patient was not active at the time of service.
[CUSTOMER][NEUTRAL] OK, swipes is bad.
[CUSTOMER][NEGATIVE] Officient, not active on data service.
[CUSTOMER][NEUTRAL] OK, just one moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What is the received date of this claim?
[AGENT][NEUTRAL] Claim was received on [PII].
[CUSTOMER][NEUTRAL] OK. And what is the process?
[AGENT][NEUTRAL] Processed [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just one moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, what is the
[CUSTOMER][NEUTRAL] Termination date.
[AGENT][NEUTRAL] Uh, let me get that for you. One moment.
[AGENT][NEUTRAL] Termination date of policy was [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so what is the claim number?
[AGENT][NEUTRAL] Claim number is 342.
[AGENT][NEUTRAL] 563 9.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just one moment.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] K.
[CUSTOMER][NEUTRAL] What is the call reference number for this one?
[AGENT][NEUTRAL] Call reference would be my name with my last initial, then today's date. My name again is [PII], that's [PII] Last initial is [PII].
[CUSTOMER][NEUTRAL] OK. Thank you, [PII]. So please just stay on the call. Uh, actually I have another claim for you.
[AGENT][NEUTRAL] Is it a different patient?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] One moment please.
[CUSTOMER][NEUTRAL] Yeah, please just stay on the call. Let me finish my note and I will give you the next member information.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah,
[CUSTOMER][NEUTRAL] One moment, ma'am.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so I'm checking here.
[CUSTOMER][NEUTRAL] Oh, let me check again.
[CUSTOMER][NEUTRAL] So I have the different providers this time.
[CUSTOMER][NEUTRAL] The NPI is 1851361778.
[AGENT][NEUTRAL] Alright, [PII], it was 185.
[CUSTOMER][NEUTRAL] OK, so I'm checking here. This is uh the, I'm talking, uh, I have the claim, which is the plan name I'm telling you.
[CUSTOMER][NEUTRAL] The insurance name is American Retirement Life. So, can you provide me the information?
[AGENT][NEUTRAL] We're American public life.
[CUSTOMER][POSITIVE] OK, thank you so much have a good day.
[AGENT][NEUTRAL] You too.