AccountId: 011433970860
ContactId: 5860dfd4-c6f0-4678-a102-70597f538a01
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 461380 ms
Total Talk Time (AGENT): 154351 ms
Total Talk Time (CUSTOMER): 84279 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/04/5860dfd4-c6f0-4678-a102-70597f538a01_20250404T12:31_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I am calling from Grand Strand Medical Center in regards to claim status.
[AGENT][NEUTRAL] OK, your name
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] You need to check claim status for a member, is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, did you say that you were needing to check claim status? Yes, ma'am, I can help you with that. And what is your name again?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] Can you spell your name for me?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK. [PII], and what is a good callback number for you please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you and the member's policy number, please?
[CUSTOMER][NEUTRAL] Yes. It is 02506178.
[AGENT][NEUTRAL] OK thank you one moment while I get the member's information pulled up please.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Any information moving that I did provide for you today would be of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] Uh, bear with me just one moment please, Mine.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so I do show she is the spouse of [PII] on the supplemental policy, and this supplemental policy is active with an effective date of [PII].
[AGENT][NEUTRAL] And what type
[AGENT][NEUTRAL] The benefit information do you need for her in patients?
[CUSTOMER][NEUTRAL] I just need the claim status.
[AGENT][POSITIVE] Oh, I'm so sorry. I'd say that and I'm trying to give you benefit information. I apologize.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] No, you're OK.
[AGENT][NEUTRAL] OK, and what is the data service and total amount, please?
[CUSTOMER][NEUTRAL] Date of service is [PII] and the bill amount is 19,942 even.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] 19942.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Is that correct?
[AGENT][POSITIVE] OK, thank you one moment.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, so for this claim was received, the received date was 12-2-2024.
[AGENT][NEUTRAL] It was processed and denied on [PII].
[AGENT][NEUTRAL] Claim number is 353-6884.
[AGENT][NEUTRAL] And the reason for the denial states to please provide copies of the explanation of benefits from the primary insurance carrier.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And Waring, we do have a portal if you need a copy of this explanation of benefits with those remarks on it you can print that now that you have the claim number by going to our website for.
[AGENT][NEUTRAL] The portal which is [PII].
[CUSTOMER][NEUTRAL] What was that portal again?
[AGENT][POSITIVE] [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Give me just a moment if you don't mind.
[AGENT][POSITIVE] Sure, absolutely.
[CUSTOMER][NEUTRAL] Alright, and then do you have a reference number for our call today?
[AGENT][POSITIVE] Uh yes ma'am you would actually use my name along with.
[AGENT][NEUTRAL] Today's date.
[CUSTOMER][POSITIVE] OK. Thank you so much, [PII].
[AGENT][POSITIVE] Well, you are certainly very welcome. Yes, ma'am. And is there anything else I can help you with this morning?
[CUSTOMER][POSITIVE] That's all. Thank you so much.
[AGENT][POSITIVE] Well, you're welcome and thank you for calling AP. Hope you have a wonderful weekend.
[CUSTOMER][NEUTRAL] You too. Bye.
[AGENT][POSITIVE] Thank you. Bye bye.