AccountId: 011433970860
ContactId: 9d2b336d-4d82-4a7d-aaae-3111d04a1d28
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 282440 ms
Total Talk Time (AGENT): 65151 ms
Total Talk Time (CUSTOMER): 85828 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/02/9d2b336d-4d82-4a7d-aaae-3111d04a1d28_20250502T16:41_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] calling from the office of Prisma Health University Medical Group to check the claim status. Could you assist me with that?
[AGENT][NEUTRAL] Yes, I can help you with claim status. I missed your name. What was your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], OK, and you have a good callback number, [PII]?
[CUSTOMER][NEUTRAL] Yeah, sure. And that's uh [PII].
[CUSTOMER][NEUTRAL] Oh extension of [PII].
[AGENT][NEUTRAL] OK, and you have the policy patient?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Policy number for the patient?
[CUSTOMER][NEUTRAL] And it's so.
[CUSTOMER][NEUTRAL] 02465467.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] And that's [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Date of service and bill charges.
[CUSTOMER][NEUTRAL] And it's for uh [PII].
[CUSTOMER][NEUTRAL] Of the amount, $1,968 even.
[CUSTOMER][NEUTRAL] And uh definitely, I do have another bill amount for the same date of service uh which is $2,315 even.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, looks like we received that on 324-25.
[AGENT][NEUTRAL] It was processed 326, 25.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Um, outpatient benefit dollar amount for calendar year has been met.
[AGENT][NEUTRAL] Are you there?
[CUSTOMER][NEUTRAL] Could you, uh, repeat once again? Is the dollar amount of Canada has been made?
[AGENT][NEUTRAL] Yes, dollar amount for policy has been met for the calendar year.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, for the both the bill amount or for uh $1,968.
[AGENT][NEGATIVE] Um, the other one that was processed, same date, um, denied for the same reason.
[CUSTOMER][NEUTRAL] Could I get the claim number for uh for the claim?
[AGENT][NEUTRAL] Uh, the first claim is 358-0902.
[AGENT][NEUTRAL] Other claim is 358.
[AGENT][NEUTRAL] 0904.
[CUSTOMER][POSITIVE] Thank you, [PII].
[AGENT][NEUTRAL] Is there anything else I can help with?
[CUSTOMER][NEUTRAL] Uh, yes, and could you fax me the?
[AGENT][NEUTRAL] What's your facts?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Could you fax me the UB?
[AGENT][NEUTRAL] Yes, what's your fax number?
[CUSTOMER][POSITIVE] Yeah, thank you.
[AGENT][NEUTRAL] You have your fax number?
[CUSTOMER][NEUTRAL] And yes, sure. And that's uh 469-420.
[CUSTOMER][NEUTRAL] 5915.
[AGENT][NEUTRAL] And you need the EOB for both dates?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Right
[AGENT][NEUTRAL] OK. Can I help with anything else?
[CUSTOMER][POSITIVE] No, [PII]. Thank you.
[AGENT][POSITIVE] Thanks for calling APL.
[CUSTOMER][NEUTRAL] Could I get the good for reference number?
[AGENT][NEUTRAL] Yes, it's my name, [PII], and today's date.
[CUSTOMER][POSITIVE] Yeah, thank you, sir.
[AGENT][POSITIVE] Thank you for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] Yeah.