AccountId: 011433970860
ContactId: 7373c050-a584-4637-a056-127c7ce8a066
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 436579 ms
Total Talk Time (AGENT): 169351 ms
Total Talk Time (CUSTOMER): 99688 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/7373c050-a584-4637-a056-127c7ce8a066_20250206T15:56_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning [PII]. I'm calling to check claim status from a provider's office.
[AGENT][NEUTRAL] OK, I can help you with claim status. Can I please get your name and your callback number?
[CUSTOMER][NEUTRAL] Yes, my name is [PII] last name initial [PII] and my callback number is [PII].
[AGENT][NEUTRAL] OK, thank you [PII]. What is the patient's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and what is [PII]'s, um, date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and [PII]'s policy number please?
[CUSTOMER][NEUTRAL] 1514338
[AGENT][NEUTRAL] Thank you and then what is the data service?
[CUSTOMER][NEUTRAL] The Data service is 9524.
[AGENT][NEUTRAL] And the charge amount please?
[CUSTOMER][NEUTRAL] 38672
[AGENT][NEUTRAL] OK let me pull in this policy real quick.
[AGENT][NEUTRAL] OK, and then what is the charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] $30 even.
[AGENT][NEUTRAL] OK and the name of the facility that you're calling from please, Ms. [PII]?
[CUSTOMER][NEUTRAL] Prisma Health Urgent Care of South Carolina.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I look up this claim for you and I'll be right back.
[CUSTOMER][POSITIVE] OK thank you
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding for me, Ms. [PII]. So looking for data service of 95 of 2024.
[AGENT][NEUTRAL] I do not find a claim on file for [PII].
[CUSTOMER][NEUTRAL] OK, and we've resubmitted this twice. Do you all take um faxed claims?
[AGENT][NEUTRAL] Yes ma'am we do um do you, do you want the fax number?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, it's [PII].
[CUSTOMER][NEUTRAL] OK, and do I need to put an attention to any certain department or person?
[AGENT][NEGATIVE] You can just put attention claims department. I've noticed that this, this policy is lap.
[AGENT][NEUTRAL] Let me see if he's got an active. No, he doesn't. I was gonna see if he had an active policy and look on that one too, but he does not have an active one.
[CUSTOMER][NEUTRAL] OK, but is this policy active for data service 9524?
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So that could be the issue.
[AGENT][NEUTRAL] It could be and let me look on the other policy even though it's lapsed just to double check and make sure um this policy.
[AGENT][NEUTRAL] Lapsed on [PII] that you gave me. Let me check this other one. I wanna make sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] No ma'am, there's not a claim on that one either.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so the other policy number is um.
[CUSTOMER][NEUTRAL] Well, that will help us.
[AGENT][NEUTRAL] 246-5459, the effective date for the policy, I'm sorry, it's [PII] I'm sorry it's 246-545-9.
[CUSTOMER][NEUTRAL] Can you give me that again?
[CUSTOMER][NEGATIVE] The phone cut out.
[AGENT][NEUTRAL] The Policy effective date was [PII].
[AGENT][NEUTRAL] And the policy terminate terminates terminated on [PII].
[CUSTOMER][NEUTRAL] OK, so this policy number though is active for data service 95.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, and that was 246-545-9?
[AGENT][NEUTRAL] Let me check it again.
[CUSTOMER][POSITIVE] I'm so sorry.
[AGENT][NEUTRAL] No, it's OK. It's what I'm here for. I wanna help you. It's 246-545-9.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so we will resubmit this with the correct ID then and.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Follow up and then if it's not been received at that point then we'll do the fax but as of right now I will just submit.
[CUSTOMER][NEUTRAL] A paper claim
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And that's the same, uh, it's the same payer though, correct?
[CUSTOMER][NEUTRAL] Which would be American public life.
[AGENT][NEUTRAL] Yes ma'am, 608001.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and do you give call reference numbers?
[AGENT][NEUTRAL] Yes ma'am, you can use my name it's [PII] and today's date.
[CUSTOMER][POSITIVE] OK, I got it thank you so much I appreciate your help on this.
[AGENT][POSITIVE] You're very welcome. I'm glad I was able to give you a little a little bit of some answers anyway so you know what direction to go in.
[CUSTOMER][POSITIVE] Right, absolutely, I appreciate it so much. Thank you. You have a wonderful day.
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. You have a great day too. Thanks for calling APL.
[CUSTOMER][NEUTRAL] Bye bye.