AccountId: 011433970860
ContactId: 0bfe0007-30e3-4b26-b363-d73f5e198b8e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 375059 ms
Total Talk Time (AGENT): 121787 ms
Total Talk Time (CUSTOMER): 156315 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/0bfe0007-30e3-4b26-b363-d73f5e198b8e_20250124T13:56_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from Prisma Health. I'm calling because I had a few claims for the same patient, uh, um, and I called 90 Degrees yesterday and 90 Degrees said that.
[CUSTOMER][NEUTRAL] Y'all handled some of the claims for the patient. It was like a split policy and I was wondering if you could look and see if you have them.
[AGENT][NEUTRAL] OK. Do you have a phone number I can get in case we get disconnected and I can call you back?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] And do you have their policy number?
[CUSTOMER][NEUTRAL] Yes, it is.
[CUSTOMER][NEUTRAL] D as in dog, 43732166.
[AGENT][NEUTRAL] That's not our policy number. Do you have their social?
[CUSTOMER][NEUTRAL] OK, so there's a different policy number also for this um split.
[AGENT][NEUTRAL] Yes, sir. That the policy is for their wellness policy.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] OK, um, should we've had two cards then because I just have that one card.
[CUSTOMER][NEUTRAL] Just curious, um, I'll.
[AGENT][NEUTRAL] Yeah, they should have uh.
[AGENT][NEUTRAL] APL card as well.
[CUSTOMER][NEUTRAL] OK, well, it, um, I will give you the social it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, hold on one moment and let me see if I can find the policy number.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Pacific, uh.
[CUSTOMER][NEGATIVE] Do not degree.
[AGENT][NEUTRAL] And you're calling for his medical policy?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] And what's his name?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Hold on just a second.
[AGENT][NEUTRAL] And his date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. Oh, and you were just needing claim status.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Sorry.
[AGENT][NEUTRAL] OK, I can look that up for you. What data service is it for?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I'm not sure we have any claims for him on this policy.
[AGENT][NEUTRAL] Hold on just a moment, we may have some mail that just came in. Hold on just a moment.
[AGENT][NEUTRAL] Let me see what it is.
[AGENT][NEUTRAL] No, that's not for that data service. That's another claim. We do not have that claim.
[CUSTOMER][NEUTRAL] OK, um, what is is there a date of service of [PII], [PII], or [PII]?
[AGENT][NEUTRAL] No, sir, we don't have any of those.
[CUSTOMER][NEUTRAL] OK, huh, OK, so did we send.
[CUSTOMER][NEUTRAL] Should we so when we're sending these claims over we're using that specific ID number for 90 Degrees their wellness plan.
[CUSTOMER][NEUTRAL] Will they come to y'all when it because it goes to I guess to the repricer.
[AGENT][NEUTRAL] Right. It goes to, um,
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] IMA yeah, to multiplan to IMA. It goes to IMA and they're supposed to forward it to us, but yeah, they would have a different policy number for us and that is 02.
[CUSTOMER][NEUTRAL] Multi-plan
[AGENT][NEUTRAL] 567 878.
[AGENT][NEUTRAL] But it's supposed to go to IMA to that uh [PII] address first.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so, oh yeah, we have this [PII] address on here, Multiplan PHCS, [PII].
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Let me give you the correct address.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's supposed to go to IMA.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Hold on one second. Uh, I am a [PII]. Go ahead.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] Egan.
[AGENT][NEUTRAL] [PII], uh-huh.
[CUSTOMER][NEUTRAL] Me, OK.
[AGENT][NEUTRAL] [PII] 55121.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Their payer ID is 64556.
[CUSTOMER][NEUTRAL] 645-56.
[AGENT][NEUTRAL] 56. Uh-huh.
[CUSTOMER][NEUTRAL] OK, so I'll update that to [PII].
[CUSTOMER][NEUTRAL] 551-21 payer ID 64556. Is there a group number for the for the um patient?
[AGENT][NEUTRAL] 70056.
[CUSTOMER][NEUTRAL] OK, wait one sec, can you repeat that one more time?
[AGENT][NEUTRAL] 70056.
[CUSTOMER][POSITIVE] OK, alright, thank you [PII], have a great weekend.
[AGENT][POSITIVE] You're welcome. Is there anything else I can help you with?
[CUSTOMER][POSITIVE] No, that's it. Thank you.
[AGENT][POSITIVE] Thank you, [PII], for calling APL. You have a good weekend as well.
[CUSTOMER][NEUTRAL] Alright bye bye.
[AGENT][NEUTRAL] Bye-bye.