AccountId: 011433970860
ContactId: a3c0bc0d-ffb8-4b7f-aaa4-ac8b882769b7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 245210 ms
Total Talk Time (AGENT): 97746 ms
Total Talk Time (CUSTOMER): 97471 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/a3c0bc0d-ffb8-4b7f-aaa4-ac8b882769b7_20250310T20:32_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII], and I'm calling from um Medical University of South Carolina in [PII], and I'm calling. I was trying to go on your website to look up claim status, but it's saying um no user were found with the information that was entered.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Well, I can assist you with claim status. Um, first, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, [PII] and that's the direct line?
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] OK, policy number is 023893887.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Patient name is [PII]. Date of birth [PII].
[AGENT][NEUTRAL] OK. Thank you. Now I need the date of service and bill charges on the claim.
[CUSTOMER][NEUTRAL] Data service is [PII] and the total charge amount is $224.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I'm not showing that claim on file. Um, how was it submitted?
[CUSTOMER][NEUTRAL] Um, it was submitted through the website. Can y'all submit claims through your website?
[AGENT][NEUTRAL] Yes, ma'am. Claims can be submitted through the website.
[CUSTOMER][NEUTRAL] OK, I have a uh confirmation number.
[AGENT][NEUTRAL] OK. And what's that number? Do you have a claim number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, she just got the confirmation number for submitting the claim, I guess it's O as in Oscar, S as in South, C as in Charlie 94229.
[AGENT][NEUTRAL] OK, and what's that number?
[AGENT][NEUTRAL] OK, here it is. OK, and I'm showing that that claim actually denied because according to the primary EOB that was submitted along with it, um, it's showing that um the primary insurance did not cover the charge. And under this policy, if the primary insurance doesn't cover a charge, then we don't cover it either as their secondary insurance.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, um, what was that process?
[AGENT][NEUTRAL] OK, that was processed on.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] We received it on [PII] and it was processed on [PII].
[CUSTOMER][POSITIVE] OK, alright, well thank you so much what was your name again?
[AGENT][NEUTRAL] Um my name is [PII]. Um it's spelled [PII] and my last initial is [PII] and my name and today's date also is the um reference number. And also, do you need the claim number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK. That claim number is 357-073-2.
[CUSTOMER][NEUTRAL] OK, let me ask you another question. So on your website we're not able to.
[CUSTOMER][NEUTRAL] Get on for some reason it's not letting us get on to your website you're having issues with it or something?
[AGENT][NEUTRAL] Yeah, we had been having issues with it earlier today. Yeah, so I guess they're still working on it.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK, alright.
[CUSTOMER][POSITIVE] OK, thank you so much and you have a good one.
[AGENT][NEUTRAL] OK, is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] No, that's it thank you.
[AGENT][POSITIVE] Mhm. Thank you again, [PII] for calling ATL. Have a great rest of your day. Mm bye.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] And