AccountId: 011433970860
ContactId: e6361aaa-b107-4ae6-abdd-d92300819fec
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 401269 ms
Total Talk Time (AGENT): 114893 ms
Total Talk Time (CUSTOMER): 75953 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/e6361aaa-b107-4ae6-abdd-d92300819fec_20250218T14:43_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII]. I'm calling from provider office to checking for claim status.
[AGENT][NEUTRAL] All right. It would be.
[CUSTOMER][NEUTRAL] Uh, sorry, appeal status.
[AGENT][POSITIVE] It would be my pleasure to assist you and you said your name is [PII]?
[CUSTOMER][NEUTRAL] That's correct, [PII]. Uh let me spell. [PII].
[AGENT][POSITIVE] So [PII], thank you. And what is a good callback number, please?
[CUSTOMER][NEUTRAL] That's going to be [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] The policy number I have.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] OK, that's 021 67817.
[AGENT][NEUTRAL] And what is the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] This is for patient.
[CUSTOMER][NEUTRAL] Date of birth [PII].
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Thank you and what is the date of service, please, sir?
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] The date of service I have [PII].
[CUSTOMER][NEUTRAL] And the claim bill for $275.
[AGENT][POSITIVE] All right, thank you, sir. I'm getting that pulled up bear with me just one moment please.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Looks like it was processed on [PII], let me get that.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Excuse me.
[AGENT][NEUTRAL] All right, that appeal was, we received it on [PII], and it was processed on [PII].
[AGENT][NEUTRAL] And it was determined that the original claim was processed correctly and in accordance with the policy contract.
[CUSTOMER][NEUTRAL] According to the policy contract, the service is not covered under the patient plan, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Can I have the letter for that, uh which is
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] Yeah, it was mailed out on [PII].
[AGENT][NEUTRAL] To the provider.
[CUSTOMER][NEUTRAL] It's um and it's uh processed under the same claim number 3341078.
[AGENT][NEUTRAL] No, sir. This is gonna be claim number 3559442.
[CUSTOMER][NEUTRAL] And uh there is one more claim uh and one more appeal for that.
[CUSTOMER][NEUTRAL] It's for the same date of service for the charges for $150.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Bear with me just one second.
[AGENT][NEUTRAL] I'm checking on that.
[AGENT][NEUTRAL] OK, that is under the same appeal.
[AGENT][NEUTRAL] That was on the same appeal so those both were.
[AGENT][NEUTRAL] Reviewed and determined that the claims were processed correctly.
[CUSTOMER][NEUTRAL] OK, I got it. What is the claim number for?
[AGENT][NEUTRAL] It's the same claim number, the same appeal, claim number.
[CUSTOMER][NEUTRAL] Can you spell your name, please?
[AGENT][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] Anything else I can assist you with today?
[AGENT][NEUTRAL] You need the call reference number?
[AGENT][NEUTRAL] Call reference number is my name and today's date, and I spell my name, [PII].
[CUSTOMER][POSITIVE] OK. Thank you so much, [PII], for this all the information. That's it. Have a nice day.
[AGENT][NEUTRAL] Uh
[AGENT][POSITIVE] I hope you have a wonderful day as well, [PII]. Thank you for calling APL. Take care.
[CUSTOMER][NEUTRAL] Yeah, bye-bye.
[AGENT][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Hm.