AccountId: 011433970860
ContactId: dd5e403c-e2b8-457d-b4a5-00c56835fcd0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 295630 ms
Total Talk Time (AGENT): 102769 ms
Total Talk Time (CUSTOMER): 88553 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/22/dd5e403c-e2b8-457d-b4a5-00c56835fcd0_20250122T16:17_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] What is your name again? I'm sorry.
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, my name is [PII] and I'm calling to check the status of a claim and find out if it's patient's responsibility, please.
[AGENT][NEUTRAL] OK, Ms. [PII], um, I can help you with claim status. Can you please give me your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And then what is the patient's name?
[CUSTOMER][NEUTRAL] Patient's name is [PII].
[AGENT][NEUTRAL] And then the patient's date of birth, please.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And patients policy number?
[CUSTOMER][NEUTRAL] It is 11,063,589,600.
[AGENT][NEUTRAL] OK, that's not one of our policy numbers.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] How about 02, wait a minute, 02389384.
[AGENT][NEUTRAL] Let me
[AGENT][NEUTRAL] The
[AGENT][NEUTRAL] That sounds more like it. Let me look her up real quick.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] The other one was an expired plan and I, I moved it.
[AGENT][NEUTRAL] Yes ma'am, I understand. OK, and what's Ms. [PII]'s date of service?
[CUSTOMER][NEUTRAL] Date of service is.
[CUSTOMER][NEUTRAL] Uh [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the charge amount?
[CUSTOMER][NEUTRAL] For 10 $173.
[AGENT][NEUTRAL] Sorry.
[AGENT][NEUTRAL] OK, and then what was the charge after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] I don't have a primary insurance on here.
[AGENT][NEUTRAL] Oh, OK, um, what is the name of the facility?
[CUSTOMER][NEUTRAL] I am calling from MUSC PPC Health West.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold, Miss [PII] while I look up this claim for you, and I'll be right back.
[CUSTOMER][POSITIVE] Thank you, ma'am.
[AGENT][POSITIVE] You're very welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] OK, thank you very much for holding for me, Ms. [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I do have the claim pulled up and the claim number is 33.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 88829.
[AGENT][NEUTRAL] And the remarks on the claim is uh
[AGENT][NEUTRAL] Benefits not payable for conditions other than sickness or injury. Policy provides no benefits for the treatment of conditions other than sickness or injury as defined by the policy.
[CUSTOMER][NEUTRAL] So, prevented injections such as flu shots, pneumonia vaccines are not covered.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And is this patient responsibility?
[AGENT][NEUTRAL] We don't offer patient responsibility that's determined by the provider.
[CUSTOMER][NEUTRAL] OK, but as far as you're concerned, it's not payable by your insurance company.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] May I have a call reference number please?
[AGENT][NEUTRAL] Yes ma'am, you can use my name it's [PII] and today's date.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] OK, I thank you very much for your time have a great day.
[AGENT][POSITIVE] You too, Miss [PII]. You have a great rest of your week and thanks for calling APL.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're very welcome. Bye-bye.