AccountId: 011433970860
ContactId: ea781d49-efd3-4a60-b3ec-6078991a25a9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 480519 ms
Total Talk Time (AGENT): 118805 ms
Total Talk Time (CUSTOMER): 178590 ms
Interruptions: 2
Overall Sentiment: AGENT=1.6, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/ea781d49-efd3-4a60-b3ec-6078991a25a9_20250218T14:19_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, my name is [PII]. I'm calling for the provider Kim Missouri Hospital Company. Please note this call will be recorded and monitored for quality and training purposes. I'm calling for to check on a claim status. Could you please spell your name, please?
[AGENT][NEUTRAL] Yes, ma'am. My name is [PII]. And I'm sorry, what was your name again?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Mhm thank you.
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][POSITIVE] Thank you, [PII]. And what is a good callback number please, ma'am?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The callback number is [PII]. It's a direct line.
[AGENT][POSITIVE] Thank you, [PII], and it would be my pleasure to assist you with claim status this morning. What is the policy number for the patient?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Mm thank you.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] The policy number is 1,341,910.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] And the patient's name and date of birth, please, ma'am.
[CUSTOMER][NEUTRAL] Sure. The patient's first name is [PII] and then last name is [PII]. The patient's date of birth is [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And I can help you with that claim status. What is the date of service, please, ma'am?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sure. The date of service is [PII].
[AGENT][NEUTRAL] And what is the bill amount, please?
[CUSTOMER][NEUTRAL] Yeah, the bill amount is $209 even, [PII].
[AGENT][NEUTRAL] And what is the facility name please, ma'am?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The facility name is
[CUSTOMER][NEUTRAL] Cooksville, Missouri Hospital Company.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] [PII], we did receive that claim on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim was processed on [PII].
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] And it was denied as office visits are not covered, and that is per the patient's plan.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Would you like a claim number?
[CUSTOMER][NEUTRAL] Yes. Wait a ma'am. Wait a second, please. Uh, I'll note it down to the information. Sorry.
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] All right. May I have the claim number, please?
[AGENT][NEUTRAL] The claim number is 354.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] 2720.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Mm thank you, [PII]. Could you please wait a moment, please, [PII], while I check this information for you. Thank you.
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] Not a problem at all. Thank you.
[CUSTOMER][POSITIVE] Thank you for your patience, [PII]. I appreciate your patience. Thank you so much.
[AGENT][NEUTRAL] No, this is
[AGENT][POSITIVE] My pleasure to assist you with that. Mhm.
[CUSTOMER][NEUTRAL] All right. May I have
[CUSTOMER][NEUTRAL] Thank you. May I have the date, please?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] May I have the dinner date, please?
[AGENT][NEUTRAL] It was denied on [PII].
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] And may I have the address, please?
[AGENT][NEUTRAL] Appeal address is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] We like
[CUSTOMER][NEUTRAL] All right. Uh, it is [PII]. Am I correct?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Yeah, may I have the timely filing limit for this appeals, please?
[AGENT][NEUTRAL] timely filing is 180 days from the date of denial.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And may I have the attention for the uh bills, please?
[AGENT][NEUTRAL] It's to the same address to the attention of appeals.
[CUSTOMER][POSITIVE] Good.
[CUSTOMER][NEUTRAL] Mhm. All right, the attention of appeals is appeals. Am I correct?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] This is a.
[CUSTOMER][NEUTRAL] Thank you, [PII]. May I have the call reference number, please?
[AGENT][NEUTRAL] Call reference number is my name and today's date, and I spell my name [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you, [PII]. Thank you for your assistance and thank you for your patience. Have a wonderful day. Bye-bye.
[AGENT][POSITIVE] It's been my pleasure to assist you, [PII]. Thank you for calling APL and I hope you have a wonderful day as well.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm bye bye.
[AGENT][NEUTRAL] Bye-bye.
[CUSTOMER][NEUTRAL] OK.