AccountId: 011433970860
ContactId: bee0d8e0-1c18-4784-8af5-10b315ff168a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 370899 ms
Total Talk Time (AGENT): 104865 ms
Total Talk Time (CUSTOMER): 124483 ms
Interruptions: 1
Overall Sentiment: AGENT=1.6, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/23/bee0d8e0-1c18-4784-8af5-10b315ff168a_20250423T16:20_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] On APL, this is [PII]. How may I help you? Good morning, Ms [PII]. My name is [PII] calling from McCloud Sea Coast Hospital. have a question about a claim that denied, please.
[AGENT][NEUTRAL] OK, I can help you, Miss um [PII] with the claim. Can I please get your callback number, ma'am just in case the call is connected.
[CUSTOMER][NEUTRAL] with the
[CUSTOMER][NEUTRAL] Your callback number ma'am just in case the call disconnected. [PII].
[AGENT][NEUTRAL] Thank you. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Thank you. And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient is [PII]. Date of birth is [PII]. ID number 02506.
[CUSTOMER][NEUTRAL] The
[AGENT][NEUTRAL] OK, and can you repeat that policy number one more time please? 0250.
[CUSTOMER][NEUTRAL] the
[CUSTOMER][NEUTRAL] 0506.
[AGENT][NEUTRAL] I'm sorry, I'm not catching the last couple.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] That's OK, 02506204.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] All right, let me look that up real quick.
[AGENT][NEUTRAL] OK, I have [PII] pulled up and what is the date of service and the charge amount?
[CUSTOMER][NEUTRAL] And what is the data service and the
[CUSTOMER][NEUTRAL] [PII] total charge $11,319.
[AGENT][NEUTRAL] OK, and then what were the charges after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Well, I guess that's the reason I'm calling. We don't show the patient having any other insurance. Uh, so you're saying this policy is secondary?
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, do you by any chance show who the primary payer is?
[AGENT][NEUTRAL] Uh, let me look on the group and see who they're.
[CUSTOMER][NEUTRAL] Let me look down the group and see who they're.
[AGENT][NEUTRAL] Insurance is through.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're very welcome.
[AGENT][NEUTRAL] Blue Cross Blue Shield of South Carolina.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK, and could I get that claim number please?
[AGENT][NEUTRAL] Uh yes ma'am. I'm gonna put you on a brief hold while I look that up and I'll be right back with you.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] And I'll be right back. OK, thank you.
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEUTRAL] I have. You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding for me, Miss [PII]. I have that claim number for you.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] For you, OK.
[AGENT][NEUTRAL] It is 350-5113.
[CUSTOMER][NEUTRAL] It's 305113. OK, we'll get in touch with the patient and get that Blue Cross information from her and what is your timely filing for a corrected claim?
[AGENT][NEUTRAL] Uh, we do not have a timely filing limit for corrections. Uh, you just need to send a letter while you're correcting it, but the client does have a remark, um.
[CUSTOMER][POSITIVE] OK, OK, great and.
[AGENT][NEUTRAL] And the remark is just that we need the explanation of benefits from the primary insurance so you should be able to just send that in and the claim would be reprocessed.
[CUSTOMER][NEUTRAL] We
[CUSTOMER][NEUTRAL] OK, great. Alright, and do y'all get call reference numbers?
[AGENT][NEUTRAL] Yes, ma'am. You can use my name [PII] and today's date.
[CUSTOMER][POSITIVE] OK, thank you for your help you have a good day.
[AGENT][POSITIVE] You too, Miss [PII]. Is that everything I can help you with today before we go?
[CUSTOMER][POSITIVE] Yes ma'am, that's it thank you.
[AGENT][POSITIVE] OK, you have a wonderful day and thanks for calling APL.
[CUSTOMER][NEUTRAL] Like I.