AccountId: 011433970860
ContactId: 9ed53a69-38a6-4c7f-9bde-4674cb10ab13
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 344079 ms
Total Talk Time (AGENT): 168515 ms
Total Talk Time (CUSTOMER): 121702 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/9ed53a69-38a6-4c7f-9bde-4674cb10ab13_20250306T15:07_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] Hi, [PII]. This is [PII] calling. I'm trying to confirm if you've all received a claim.
[AGENT][NEUTRAL] OK. Did you say that your name is [PII]?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, and you're wanting to verify if we've received a claim for a member, is that correct, [PII]?
[CUSTOMER][NEUTRAL] That's correct. I'm calling from MUSC physicians.
[AGENT][NEUTRAL] MUSC, is that correct?
[CUSTOMER][NEUTRAL] Yes, uh-huh.
[AGENT][POSITIVE] OK, thank you and what is a good call back number for you please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And the member's policy number, please, [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am. Policy number is 022.
[CUSTOMER][NEUTRAL] 92666
[AGENT][NEUTRAL] OK, thank you one moment please while I get the member's information pulled up.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And [PII], any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] And her date of birth?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] OK, thank you one moment.
[AGENT][NEUTRAL] And what is the date of service and total bill amount for her place, [PII]?
[CUSTOMER][NEUTRAL] [PII], billed amount is $277 even.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, and again, you did say that the data service is 925 of 2024. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so we do not have a claim on file for her for that data service.
[CUSTOMER][NEUTRAL] OK, can I confirm the mailing address because I did um mail it on the [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, yes ma'am, what address do you have?
[CUSTOMER][NEUTRAL] Excuse me, [PII].
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So, as of now, no, ma'am, we have not received that [PII]. Now, if you are going to resubmit that to us, please also include a copy of her primary insurance company's explanation of benefits because we will also have to have that for review.
[CUSTOMER][NEUTRAL] 0.
[CUSTOMER][NEUTRAL] Of course. OK. Well, do you give reference numbers, Mr. OK.
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] I do. You will like no that's OK. You'll use my name along with today's date and then also [PII], you may already be aware of this, but we do have a portal that you should be able to check our claim status once the claim has been processed, and our website for the portal is secured. [PII].
[CUSTOMER][NEUTRAL] OK, yes ma'am. I did try to utilize it when I um.
[CUSTOMER][NEUTRAL] I click the option for new user, which prompts for me to make a decision of medical provider and everything.
[AGENT][POSITIVE] That is correct. Uh-huh.
[CUSTOMER][NEUTRAL] And I, I did that and I entered in the tax ID information and the patient account number and I click next and, and it prompts for me to call so that's what I did. I called the number.
[AGENT][NEUTRAL] OK, now the patient account, OK, so I just wanna make sure because some people get confused on that. On the patient account number, did you enter the account number that you all have for the number or did you use her APL policy number for that?
[CUSTOMER][NEUTRAL] I entered the number that I gave you, um.
[AGENT][NEUTRAL] OK, so that is actually asking for the provider's patient account number, the account number that you all file on the claim, I think it's in box 26.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] On the claim form, but if there is not a claim on file for her, [PII], that would have also given you an error message as well.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So again, it'll be once the claim has been processed because the patient account number, yes, ma'am, it's referring to the, I believe it's box 26.
[CUSTOMER][NEUTRAL] Yes ma'am, it, it is, and I, I just tried to enter and it did give the option but you, you've already confirmed that you guys don't have it, but that is good to know for future reference.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] OK, yes, ma'am.
[AGENT][NEUTRAL] Well, is there anything else, [PII] that I could help you with at the moment?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Uh, no, ma'am. Thank you so much.
[AGENT][POSITIVE] Well, you are certainly very welcome and thank you again for calling APL. I hope you have a wonderful day.
[CUSTOMER][POSITIVE] You as well. Thank you.
[AGENT][POSITIVE] Yes, thank you, same, same to you and thank you also.
[CUSTOMER][NEUTRAL] OK, bye bye.
[AGENT][NEUTRAL] OK, bye-bye.