AccountId: 011433970860
ContactId: 80c6ba4d-b0ff-4e8c-92f5-160423fa09aa
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 284170 ms
Total Talk Time (AGENT): 119286 ms
Total Talk Time (CUSTOMER): 78997 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/80c6ba4d-b0ff-4e8c-92f5-160423fa09aa_20250523T17:18_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, my name is [PII]. I'm calling from Prisma Health Hillcrest Hospital.
[CUSTOMER][NEUTRAL] And I had um talked to you guys previously and you were needing information from patients employer. I'm calling to see if you've got that information to process a claim.
[AGENT][NEUTRAL] OK, [PII], I can help you. Do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, policy number is.
[CUSTOMER][NEUTRAL] 02230028
[AGENT][NEUTRAL] And what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEGATIVE] You're breaking in and out. Can you repeat your phone number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK. Thank you.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what's the date of service of the claim?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the total bill?
[CUSTOMER][NEUTRAL] $11,908.10.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And this would be for the emergency room charge, the facility charge?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so the patient was not eligible um during that date of service.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You know, the policy has since turned, um, effective [PII], but this claim date of services [PII], they were not eligible on that day.
[CUSTOMER][NEUTRAL] Because of premium
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So that claim was denied.
[CUSTOMER][NEUTRAL] I'm sorry, when did you say it turned 12224?
[AGENT][NEUTRAL] 9 [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] I think these are like temp services um sometimes they may work or not work and when I say they they weren't eligible for the [PII] date of service that would could be why.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, I'm just putting not eligible on data service.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Do you have um an updated remit? Do you have an updated remit that says that I can have?
[AGENT][NEUTRAL] Uh huh so the one that you have, does it say, what does it say?
[CUSTOMER][NEUTRAL] I've got
[CUSTOMER][NEUTRAL] It just says we're waiting on information to confirm eligibility.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] From benefits and a card.
[AGENT][NEUTRAL] Give me 1 2nd.
[CUSTOMER][NEUTRAL] And if I have one a a more recent one where it's denied.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, we did mail it out um.
[CUSTOMER][NEUTRAL] I can scan it in.
[AGENT][NEUTRAL] Actually back on in [PII] and it can be downloaded. Do you have an online account set up for this provider's office?
[CUSTOMER][NEUTRAL] I do.
[AGENT][NEUTRAL] Um, you can down
[CUSTOMER][NEUTRAL] Yeah, mhm.
[AGENT][NEUTRAL] You can download it from our website using the the claim number that I can give to you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me know when you're ready.
[CUSTOMER][POSITIVE] Ready.
[AGENT][NEUTRAL] Um, it's 354. I'm sorry, 351.
[CUSTOMER][POSITIVE] Yeah, I'm ready.
[AGENT][NEUTRAL] 3414.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And when you get to the to the website um you can do the quick search and it only requires the claim number, the patient's name, and the patient's date of birth.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] I'll do that thank you so much. I appreciate your help and can I have your name and first initial to your last name?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Mhm. You can. You'll use my name in today's date as your reference. It's [PII]. And anything else, [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That'll be all you have a great weekend.
[AGENT][POSITIVE] Uh, you too, thanks for calling APL. Have a good day.
[CUSTOMER][POSITIVE] Thanks bye bye.
[CUSTOMER][NEUTRAL] You too.