AccountId: 011433970860
ContactId: bc670ac1-60c1-4b50-81cd-0c6a5db5c569
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 382130 ms
Total Talk Time (AGENT): 113735 ms
Total Talk Time (CUSTOMER): 174182 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/bc670ac1-60c1-4b50-81cd-0c6a5db5c569_20250128T18:39_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, yes, [PII], my name is [PII]. I'm calling from Roper Saint Francis Mount Pleasant Hospital, and I'm checking claim status, please.
[AGENT][NEUTRAL] I can help you, [PII]. What's the policy number?
[CUSTOMER][NEUTRAL] 02265945
[AGENT][NEUTRAL] I get phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It is for [PII]. Her date of birth is [PII].
[AGENT][NEUTRAL] Does she go by another name?
[CUSTOMER][NEUTRAL] Um, let me check her driver's license, see if I got a copy of that and just check to see.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] Mhm. Do you have a mailing address for her?
[CUSTOMER][NEUTRAL] I have
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Her [PII] address, her, she moved to [PII] [PII].
[AGENT][NEUTRAL] OK, give me the complete address.
[AGENT][NEUTRAL] And what was the address you gave me a [PII] address before?
[CUSTOMER][NEUTRAL] Let me see what her.
[CUSTOMER][NEUTRAL] Her driver's license shows [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, then.
[AGENT][NEUTRAL] That's the one we have, OK.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] And you said that you're checking for a claim status?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, I can help you with that. What's the date of service in charge?
[CUSTOMER][NEUTRAL] It is [PII] for $21,333.80.
[AGENT][NEUTRAL] OK, inpatient claim?
[CUSTOMER][NEUTRAL] No ma'am, it's outpatient.
[AGENT][NEUTRAL] It's outpatient.
[AGENT][NEUTRAL] OK, I'm not showing up a facility charge on file for that data service.
[CUSTOMER][NEUTRAL] OK, um, this was actually sent.
[CUSTOMER][NEUTRAL] On [PII].
[CUSTOMER][NEUTRAL] Uh, [PII] and it looks like it was mailed to.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That's when it was sent.
[AGENT][NEUTRAL] Mhm. What's the name of the hospital?
[CUSTOMER][NEUTRAL] It is Roper Saint Francis Mount Pleasant.
[AGENT][NEUTRAL] OK, I'm not showing that claim received [PII]. I see charges related to that inpatient stay but not the facility charge.
[CUSTOMER][NEUTRAL] OK, yeah, yeah, because see this was um an outpatient um.
[CUSTOMER][NEUTRAL] What is a timely filing for?
[AGENT][NEUTRAL] There's not a timely filing limit in which to submit a claim.
[CUSTOMER][NEUTRAL] Oh OK and um is the patient was a patient covered on that data service?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, because we did get some kind of document that she wasn't so that was one of the other reasons why I was calling um I'll get this resubmitted.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What did the documents say?
[CUSTOMER][NEUTRAL] Um, it just said that the patient could not be found.
[CUSTOMER][NEUTRAL] Um, these services were rendered after coverage was terminated.
[AGENT][NEUTRAL] That's from American Public Life.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Is your claim number on that document that you have? Or they couldn't process it because they couldn't find anything? Is there a policy? Mhm, hm.
[CUSTOMER][NEUTRAL] Probably.
[CUSTOMER][NEUTRAL] It was a policy number 02100245. Um, I'll get this um I'll get this resubmitted. Do you give reference numbers?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, you'll use my name in today's date as your reference. [PII].
[AGENT][NEUTRAL] ONYA first initial of my last name is um [PII] and I do see that policy number, that's an old policy number for her. I don't show the date of service under that number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, but that policy, let's see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I need to give you the
[AGENT][NEUTRAL] See that policy termed in 22 and so the policy number that you gave me, [PII] date of service falls within that span of uh eligibility dates, but at any rate, that is the correct PO box.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and um the, the new policy number that I have for her was 02265945, is that still correct?
[AGENT][NEUTRAL] Mhm it's not the most recent, but it fall that's the one you'll use for the data service in question.
[CUSTOMER][POSITIVE] OK, OK, great, thank you so much for your help you have a good day.
[AGENT][POSITIVE] You're welcome, [PII]. Any other questions I can help out with today?
[CUSTOMER][POSITIVE] No, ma'am. You have a good day. Bye bye.
[AGENT][POSITIVE] You too, thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Bye-bye.