AccountId: 011433970860
ContactId: 08b253d7-71b9-477e-84d8-5edf4de8efcc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 437079 ms
Total Talk Time (AGENT): 163939 ms
Total Talk Time (CUSTOMER): 114722 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/08b253d7-71b9-477e-84d8-5edf4de8efcc_20250326T17:28_UTC.wav
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[AGENT][POSITIVE] Good afternoon, thank you for calling APO. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII], and I'm calling from provider office to check on my claim status.
[AGENT][NEUTRAL] OK, sure. I can assist you with claim status, and I'm sorry, I didn't quite catch your name. Can you repeat your name?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] And my callback number is [PII].
[AGENT][NEUTRAL] OK, and you're calling from which facility from my location?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Prisma Health University.
[AGENT][NEUTRAL] It
[CUSTOMER][NEUTRAL] OK, can you provide, uh, spell me your name for my documentation purpose, please?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure. My name is [PII].
[CUSTOMER][POSITIVE] Thank you so much for that, sir.
[AGENT][NEUTRAL] You're welcome. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah, that will be.
[CUSTOMER][NEUTRAL] 01881692.
[AGENT][POSITIVE] OK, thank you. Um.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yeah, the patient name is
[CUSTOMER][NEUTRAL] [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] The date of service is [PII] and the bill amount is $1,148 even.
[AGENT][NEUTRAL] OK, thank you. And let me see if I can find this claim, and that was [PII] for 1,148. And for future, you can check claim status online through our website at [PII] and that's just optional. You can always call and let's see. What are the procedure codes uh for your claim or is it a facility charge?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Um, the procedure code 55,700.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, here it is. OK, let me pull that be one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] I'm waiting on the UB, OK? One moment.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] All right, so, um,
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] The amount on this one is a little bit different. Do you want to check the amount just to make sure I'm looking at the right one?
[CUSTOMER][NEUTRAL] It's uh.
[CUSTOMER][NEUTRAL] $1,148 even.
[AGENT][NEUTRAL] Um, that's not the amount I got here.
[AGENT][NEUTRAL] Can you check your plane again?
[CUSTOMER][NEUTRAL] Is this for
[CUSTOMER][NEUTRAL] Is this for the provider, [PII]?
[AGENT][NEUTRAL] Uh, let me pull that.
[AGENT][NEUTRAL] 1500 for one moment.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] I'm waiting on the documents to pull up.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No.
[AGENT][NEGATIVE] No, so it looks like we have not received the one for [PII].
[CUSTOMER][NEUTRAL] OK, uh,
[CUSTOMER][NEUTRAL] What is the claim mailing address?
[CUSTOMER][NEUTRAL] No
[AGENT][NEUTRAL] The mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] OK. Give me a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Um, what's the payer ID?
[AGENT][NEUTRAL] OK, so this one needs to be sent by fax or mail because we need the primary EOB attached to it. Um, I can give you the, the, that number just for reference, but you can send it by mail or fax only, OK? So the PR ID is 60801.
[CUSTOMER][NEUTRAL] 608
[AGENT][NEUTRAL] 01.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, what's the timely filing limit to submit a claim?
[AGENT][NEGATIVE] We don't have timely filing limits.
[CUSTOMER][NEUTRAL] No time with filing in, right?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK. And
[CUSTOMER][NEUTRAL] I'm sorry. Uh, how can I check for this patient [PII] effective on the date of service?
[AGENT][NEUTRAL] OK, uh, yes, I can give you the effective date. Bear with me just a second. Let me go back to it.
[AGENT][NEUTRAL] All right. So this policy was effective from [PII] and it terminated [PII]. Well, it will terminate on [PII].
[CUSTOMER][NEUTRAL] 2
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, um, uh, so thank you so much for that. And can I have the call reference for our conversation?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will.
[CUSTOMER][POSITIVE] Yes, thank you so much uh for that. You have a wonderful day.
[AGENT][POSITIVE] You as well thank you for calling APL. bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Hm.