AccountId: 011433970860
ContactId: 88960403-ca50-4f23-8550-b5dab5637b3d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 323959 ms
Total Talk Time (AGENT): 141651 ms
Total Talk Time (CUSTOMER): 76542 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/19/88960403-ca50-4f23-8550-b5dab5637b3d_20250619T18:21_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] This is [PII]. I'm calling from Edgefield County Healthcare. I'm calling with a question on a claim.
[AGENT][NEUTRAL] OK, sure, I can assist you with claims, Miss [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Uh, policy number I have is.
[CUSTOMER][NEUTRAL] 02504680.
[AGENT][NEUTRAL] OK. May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, here we go. And you say you need claim status for what date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] How much is the total charge?
[CUSTOMER][NEUTRAL] Uh, that is for it's a bill amount of 352 58.
[AGENT][NEUTRAL] OK, and I'm sorry, can you repeat the um facility name again?
[CUSTOMER][NEUTRAL] It's Edgefield County Healthcare.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you. All right, let me see if I can find this claim for future. You can check claim status online through our website at [PII], and that's just optional. And let's see, let me see if this is your claim. One moment.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And you said it was $352.58?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Let me look at this.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Um, I don't have one for that amount, Miss [PII].
[CUSTOMER][NEUTRAL] OK, are the claims supposed to be submitted to the APL or do they go to the IMA or um where do the claims need to go or is there a fax number?
[AGENT][NEUTRAL] OK, let me check and see on this 11 moment, let's see. OK, so this particular group, um, this one has an indemnity plan which it goes to IMA so it goes to IMA before it comes to us. So what we have for IMA is an address and a payer ID.
[CUSTOMER][NEUTRAL] OK, because that's where it was submitted was um.
[CUSTOMER][NEUTRAL] This was submitted to IMA back in January.
[AGENT][NEUTRAL] Mm, OK. What is the procedure code that you're looking for or the name of the provider?
[CUSTOMER][NEUTRAL] Uh, the providers Edgefield County Healthcare.
[AGENT][NEUTRAL] And the provider of service, the physician.
[CUSTOMER][NEUTRAL] Uh, that is.
[CUSTOMER][NEUTRAL] It'd be for [PII].
[CUSTOMER][NEUTRAL] For code 99282.
[AGENT][NEUTRAL] OK. Do you know
[AGENT][NEUTRAL] 282. OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEGATIVE] Yeah, we have not received that one. We have received the one for code 99283 for [PII] for Edgefield County Healthcare. This is the only one that we have received.
[AGENT][NEUTRAL] The amount is different.
[CUSTOMER][NEUTRAL] OK, um, by chance, is there a fax number of these could be submitted to? I mean, I have the mailing address we're showing the PO box.
[AGENT][NEUTRAL] Mm mm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII], yes.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes. That is the correct address. We do not have a fax number. I only have a payer ID.
[CUSTOMER][NEUTRAL] Uh, what's the payer ID?
[AGENT][NEUTRAL] Payer ID is 64556.
[CUSTOMER][NEUTRAL] OK, is there a reference number for the call?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will. Do you need the spelling of my name or any other information?
[CUSTOMER][NEUTRAL] Uh, and
[CUSTOMER][NEUTRAL] Yeah, there's not the spelling of the name.
[AGENT][NEUTRAL] 7. OK, sure. That's [PII], last initial [PII].
[CUSTOMER][NEUTRAL] So it's [PII]
[AGENT][NEUTRAL] Yes, uh-huh.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][POSITIVE] Alright, I appreciate it.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good afternoon, Miss [PII].
[CUSTOMER][NEUTRAL] You too, bye bye.
[AGENT][POSITIVE] Thank you. Bye bye.