AccountId: 011433970860
ContactId: 3ed8dea2-7fe9-4c50-83d3-9c32d94dcc0c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 449260 ms
Total Talk Time (AGENT): 111632 ms
Total Talk Time (CUSTOMER): 169702 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/3ed8dea2-7fe9-4c50-83d3-9c32d94dcc0c_20250414T14:46_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm calling from provider's office to check on claim status. Could you please assist me?
[AGENT][NEUTRAL] Yes, I can help you with claim status, [PII]. Um, what provider's office?
[CUSTOMER][NEUTRAL] Yeah, this is Prisma Health University Medical Group.
[AGENT][NEUTRAL] OK, do you have a good callback number?
[CUSTOMER][NEUTRAL] Sure. It is [PII] with an [PII] [PII].
[AGENT][NEUTRAL] And do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Yes, that is 024384 and 50.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] OK, which is [PII] and date of birth was on [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Yeah, and could you please spell me your name?
[AGENT][NEUTRAL] Uh, my name is [PII]
[CUSTOMER][POSITIVE] Uh thank you so much. And what's your last name is [PII]?
[AGENT][NEUTRAL] Uh, first initial to last name is [PII].
[CUSTOMER][POSITIVE] [PII]. Thank you.
[AGENT][NEUTRAL] And then what was that date of service, [PII]?
[CUSTOMER][NEUTRAL] Yes, the data service was on [PII].
[AGENT][NEUTRAL] And the bill charges?
[CUSTOMER][NEUTRAL] OK, there are two charge amount. The first one is that $1,494 even $1494 and $1,476 even 1476.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let's see.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, it looks like for the 1,494.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] OK, looks like we received it on [PII], process 10-11-2024.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Uh, maximum benefit payable for the date er date of service was met.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So is it the dollar value?
[AGENT][NEUTRAL] Uh, let me see.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Yeah, OK, thank you, [PII]. OK, and may it the claimable for this one.
[AGENT][NEUTRAL] 351-6504.
[CUSTOMER][NEUTRAL] OK. Uh yeah.
[CUSTOMER][NEUTRAL] And you say the max has been met and what is the total amount which is allocated for the patient?
[AGENT][NEUTRAL] Um, it was
[AGENT][NEUTRAL] Uh, maximum is $500 per calendar day.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] So on a good day, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I just want to know, can you please please fax me the copy of a UB.
[AGENT][NEUTRAL] Sure, what's your facts?
[CUSTOMER][NEUTRAL] OK, which is [PII]. And with attention to my name, [PII].
[AGENT][NEUTRAL] OK, [PII], I'll get that faxed over, and then are you ready for the other date?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Sure, I'm ready for that one. Please proceed.
[AGENT][NEUTRAL] And for the [PII].
[AGENT][NEUTRAL] Looks like we received that [PII], same date, uh process [PII], and looks like.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] That was the same denial, maximum benefit payable for the date of service was met.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK, if that's the case, [PII], I just want to know what was the amount of for the charge amount the, the earlier amount has been paid?
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Yeah, the $500 per calendar day it was paid on another claim.
[CUSTOMER][NEUTRAL] Another claim I get the claim number or I just want to check if if it is under the same number or like.
[CUSTOMER][NEUTRAL] With the rendering provider.
[AGENT][NEUTRAL] Um, we can only give it to the provider that build the services.
[AGENT][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I can just give you status on the claims that you've asked about.
[CUSTOMER][POSITIVE] Oh OK, no problem.
[CUSTOMER][NEUTRAL] Yeah, OK, sure, no problem, and may I get the claim number for this one.
[AGENT][NEUTRAL] Uh, that claim number is 3516511.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 351-651-1
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure, [PII], that's all for now. I just want the copy from you before this one too.
[AGENT][NEUTRAL] OK, I'll get that faxed over. It just about 2 minutes.
[CUSTOMER][NEUTRAL] Yup, and
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Sure, thank you.
[CUSTOMER][NEUTRAL] And about the other claim, [PII], you say, the claim number it has extra characters. Can you please confirm that one which is 351-65404?
[AGENT][NEUTRAL] 351-6504.
[CUSTOMER][NEUTRAL] A what?
[CUSTOMER][POSITIVE] 04. OK, thank you.
[CUSTOMER][NEUTRAL] Sure, that's all for now and
[CUSTOMER][POSITIVE] Yeah, thank you so much for your assistance and just more information is that when can I expect the uh pay for you be?
[AGENT][NEUTRAL] Uh, just about 5 minutes, it should be over.
[CUSTOMER][POSITIVE] Oh, OK. Great, thank you so much for your greater assistance to me, and I just the call first.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] A call reference is just my name, [PII], first initial to last name, [PII], and today's date.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK. Really, thank you so much. I uh have a great day. Take care.
[AGENT][POSITIVE] Thank you for calling APL. You too.
[CUSTOMER][POSITIVE] Bye. Thank you.