AccountId: 011433970860
ContactId: 8527109e-18a4-4f74-a04b-33de91f50904
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 242070 ms
Total Talk Time (AGENT): 83579 ms
Total Talk Time (CUSTOMER): 57647 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/8527109e-18a4-4f74-a04b-33de91f50904_20250529T14:00_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] Yes, my name is [PII]. I need help with a uh claim please.
[AGENT][NEUTRAL] OK, [PII], are you needing claim status?
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] Yes, I can help you with that, [PII]. And what is your callback number?
[CUSTOMER][NEUTRAL] That's [PII] and that is direct.
[AGENT][NEUTRAL] Thank you. And the member's policy number, please?
[CUSTOMER][NEUTRAL] That is 1974208.
[AGENT][NEUTRAL] OK, thank you, one moment.
[AGENT][NEUTRAL] And any information, [PII], that I do provide today will be a verification of benefits and not a guarantee of payment. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the date of service and total bill amount?
[CUSTOMER][NEUTRAL] That is [PII]. That is for $7,374.60.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the name of the provider for this claim or the facility?
[CUSTOMER][NEUTRAL] Uh, Prisma Health Upstate, it may be under Baptist Easley Hospital.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, so I do not show a claim for that bill amount for this number for those dates of service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, let me see here.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You said 7,0003?
[CUSTOMER][NEUTRAL] I've got address.
[AGENT][NEUTRAL] I'm sorry, $7,374.60. Is that correct?
[CUSTOMER][NEGATIVE] Go ahead, no.
[CUSTOMER][POSITIVE] That is correct.
[AGENT][NEUTRAL] Yes, ma'am. No, I do not have a claim for that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I've got address [PII].
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] All right, we will resubmit.
[AGENT][NEUTRAL] OK, well, and then once you do, and once the claim has been processed, we do have a portal, [PII], in which you all should be able to check claim status and, and the website for the portal is located at [PII].
[CUSTOMER][NEUTRAL] Sure
[CUSTOMER][NEUTRAL] All right, and if I could just get a call reference number for today.
[AGENT][NEUTRAL] Sure, you would use my name that I gave you along with today's date.
[CUSTOMER][POSITIVE] All right perfect thank you very much you have a great day.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] I hope you do too, [PII], and if that's all I can help you with, thank you again for calling APL.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][POSITIVE] You're welcome. Bye bye.