AccountId: 011433970860
ContactId: 7b91483d-7deb-4840-a76a-6339dd16b0a2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 378000 ms
Total Talk Time (AGENT): 182301 ms
Total Talk Time (CUSTOMER): 98545 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/26/7b91483d-7deb-4840-a76a-6339dd16b0a2_20250226T19:19_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, [PII]. My name is [PII] and I'm trying to get a claim status update, please.
[AGENT][POSITIVE] [PII], it would be my pleasure to assist you with that claim status. What is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] Yes, it is 02442082.
[AGENT][POSITIVE] Thank you and what is a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII]. And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's gonna be for [PII]. Date of birth [PII].
[AGENT][POSITIVE] Thank you and it would be my pleasure to assist you with that claim status for [PII]. What is the data service?
[CUSTOMER][NEUTRAL] 11 4 24.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So bear with me just one moment, the policy number you gave me is no longer active.
[AGENT][NEUTRAL] As of [PII].
[AGENT][NEUTRAL] Oh, and does have active coverage under another policy number. Can I give you the active policy information?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] As of [PII], his active policy number is 243.
[AGENT][NEUTRAL] 8450.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me
[AGENT][NEUTRAL] Get that policy pulled up.
[AGENT][POSITIVE] And I'll be happy to check that claim status for you.
[AGENT][NEUTRAL] And that again was for data service 11 924?
[CUSTOMER][NEUTRAL] 11 4 24.
[AGENT][NEUTRAL] Sorry, I couldn't read my own writing. You're right, it does say 11 4 24.
[CUSTOMER][NEUTRAL] 49, close to the same thing.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] It kind of look like the same with my scratchy right.
[AGENT][NEUTRAL] You just slow down and right. What is that bill amount, please?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It is $522 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see, I'm trying to get to the original claim looks like we received it several times. So let me get to the original claim number.
[AGENT][NEUTRAL] Get that. What is the facility name?
[CUSTOMER][NEUTRAL] Prisma Health Urgent Care, South Carolina.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Alright, we did receive that original claim on [PII].
[AGENT][NEUTRAL] And processed on [PII].
[AGENT][NEUTRAL] With a payment of $259.19 to Prisma Health Urgent Care South Carolina.
[CUSTOMER][NEUTRAL] OK. I is there payment detail information?
[AGENT][NEUTRAL] Yes, it was a single paper check.
[AGENT][NEUTRAL] Check number is 2,018,470.
[AGENT][NEUTRAL] In the amount of 259. 19.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And what was the issue date?
[AGENT][NEUTRAL] On [PII], I'm sorry, [PII].
[CUSTOMER][NEUTRAL] [PII]. OK. And can I verify the address that check was mailed to?
[AGENT][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] OK. Is there by chance an EOB that I could get?
[AGENT][NEUTRAL] Yes ma'am, there's two ways I can fax.
[AGENT][NEUTRAL] The EOB to you or the quickest way is to go to our provider portal at [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][POSITIVE] And if you don't have an account, I can help you create an account super quick and that you'll be you'll have it instantly.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't have the claim number either.
[AGENT][NEUTRAL] I'm gonna give that to you.
[CUSTOMER][NEUTRAL] OK. What? Wait a minute, what?
[AGENT][NEUTRAL] And that way,
[AGENT][NEUTRAL] What, what? What, what?
[CUSTOMER][NEUTRAL] My computer is going all crazy. It's
[CUSTOMER][NEUTRAL] Not
[CUSTOMER][NEUTRAL] When I, it says, did you mean to be on [PII]? Let's see what it does.
[CUSTOMER][NEUTRAL] OK. Um,
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] An account
[CUSTOMER][NEUTRAL] I have an account that pulls up under APL. Now it's under the [PII], but I can't pull anything up because the last 4 of the primary insured isn't in his account, so I can't pull anything up. That's why I always have to call.
[AGENT][NEUTRAL] Oh,
[AGENT][NEUTRAL] Yeah, I can give you that claim number. So on the quick reference or the quick um access, all you have to do is put the patient's first name, his date of birth, and the claim number for that EOB.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, great.
[AGENT][NEUTRAL] And just tell me when you're ready for the claim number.
[CUSTOMER][NEUTRAL] Yes, ma'am. Go ahead.
[AGENT][NEUTRAL] Claim number is 354.
[AGENT][NEUTRAL] 1589.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, and is there a reference number I can notate for our call today?
[AGENT][NEUTRAL] The reference number is my name and today's date, and I spell my name [PII]. Anything else I can help you with today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That's it. Thank you.
[AGENT][POSITIVE] [PII], thank you for calling APL. I hope you have a wonderful day.
[CUSTOMER][POSITIVE] Thank you. You too. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.