AccountId: 011433970860
ContactId: f5448629-27bd-435f-a5c5-015a52df97bf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 479739 ms
Total Talk Time (AGENT): 206766 ms
Total Talk Time (CUSTOMER): 327739 ms
Interruptions: 20
Overall Sentiment: AGENT=1.2, CUSTOMER=1.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/f5448629-27bd-435f-a5c5-015a52df97bf_20250407T15:52_UTC.wav
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[AGENT][POSITIVE] Good morning thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] For calling, my name is [PII]. How may I help you? Hi, [PII]. My name is [PII] calling from MUSA physicians to check on a claim status.
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] [PII], it would be my pleasure to assist you with claim status. What is a good callback number?
[CUSTOMER][POSITIVE] it would be my pleasure to assist you with claim status. What is your callback number? Thank you so much. The callback number is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] Uh, sure. That is um 01639200.
[AGENT][NEUTRAL] And the patient's name and date of birth, please, ma'am?
[CUSTOMER][NEUTRAL] Um, yeah, sure. Uh, [PII]. The date of birth is [PII].
[AGENT][NEUTRAL] All right, thank you, and I can help you with that claim status for [PII], what is the date of service, please?
[CUSTOMER][NEUTRAL] OK, thank you. You're welcome. I can help you with that claim status from our. Thank you so much. Service, please. Uh, the date of service is [PII].
[AGENT][NEUTRAL] And they build them out, please.
[CUSTOMER][NEUTRAL] Uh, this is for $277 even.
[AGENT][POSITIVE] Thank you. And finally, [PII], what is the facility name?
[CUSTOMER][NEUTRAL] Uh, the facility is, um, MUSC physicians.
[AGENT][POSITIVE] Thank you. It would be my pleasure to assist you with that claim status. [PII], we did receive that claim on 3. My pleasure. We did receive the claim on 331-25.
[CUSTOMER][POSITIVE] You're welcome. Thank you so much. See that claim on 3. My pleasure.
[CUSTOMER][NEUTRAL] on 3125 OK.
[AGENT][NEUTRAL] It was processed on 4 125.
[CUSTOMER][NEUTRAL] Process on 15. OK.
[AGENT][NEUTRAL] And it was denied, and the denial reason is the services were rendered after the policy termed.
[CUSTOMER][NEUTRAL] It was denied and services were rendered after the policy term. Oh, OK.
[AGENT][NEUTRAL] This policy termed on 5-1-2024.
[CUSTOMER][NEUTRAL] When
[CUSTOMER][POSITIVE] 51-2024. OK, thank you so much. When was the policy effective date?
[AGENT][NEUTRAL] Effective date was [PII].
[CUSTOMER][POSITIVE] If I said [PII]. Thank you so much. Uh, just give me a quick moment.
[AGENT][NEUTRAL] And also [PII], I can provide that claim number if you'd like.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] Oh yes, please.
[AGENT][NEUTRAL] The claim number is 358.
[AGENT][NEUTRAL] 384 3.
[CUSTOMER][POSITIVE] 58. OK. 83. Thank you so much [PII]. uh, just a quick moment I just want to clarify some things on my end uh just a quick moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Thank you so much for your patience.
[AGENT][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, does this member have any other active policy on your file?
[AGENT][NEUTRAL] Not with APL.
[CUSTOMER][POSITIVE] That would be. Oh thank you so much, [PII] and could you please uh send us copy of you with your fax number?
[AGENT][NEUTRAL] EOBs are obtainable on our provider portal at [PII].
[CUSTOMER][NEUTRAL] Yours are obtainable on our provider portal at [PII] website you'll um that instantly. Thank you. So do we need to, uh, register first, or it's just an open portal?
[AGENT][NEUTRAL] And from that website you'll um that ELB will be downloaded instantly.
[AGENT][POSITIVE] If you need to register first and I will be happy to assist you with registering for and getting that EOB if you'd like.
[CUSTOMER][POSITIVE] registered person, I will be happy to assist you with registering your first name at that EOB if you'd like. Oh, yes, please.
[AGENT][NEUTRAL] Yes, ma'am. If you will go to secured, that's [PII].
[CUSTOMER][NEUTRAL] If you will go to, that's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. Yes.
[AGENT][NEUTRAL] You're gonna go in as a new user.
[CUSTOMER][NEUTRAL] I'm in the Yes sir. New user OK I'm in the the options. Uh.
[AGENT][NEUTRAL] And you're gonna choose the last option.
[AGENT][NEUTRAL] You're gonna choose the last option. I'm a medical or dental provider.
[CUSTOMER][NEUTRAL] Uh, OK.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] Mhm. And then you're gonna just
[CUSTOMER][NEUTRAL] Uh, actually, I, I'm a manager.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Uh, actually, OK, medical or dental provider. Thank you so much. Next.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] You're gonna put in your tax ID number and when it comes to the patient account number if you'll let me know, I can provide that for you so you don't have to look it up.
[CUSTOMER][NEUTRAL] Your tax ID number when it comes to the patient account. Now I can provide that for you. OK, um, actually, I have the tax ID number.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then the patient's account number is always listed on box 26 on the HCA, but I've got that in front of me so you don't have to look it up.
[CUSTOMER][NEUTRAL] I see.
[CUSTOMER][NEUTRAL] on 26 on the head. I've got so you don't have to look it up. OK. Oh yes, please.
[AGENT][NEUTRAL] It's 104.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 064.
[CUSTOMER][NEUTRAL] 064 OK.
[AGENT][NEUTRAL] 486.
[CUSTOMER][NEUTRAL] 486. OK.
[AGENT][NEUTRAL] 1310.
[CUSTOMER][POSITIVE] 1310. Thank you so much.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, then we need to put next.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And it's asking me to create your account.
[AGENT][POSITIVE] Tha[PII] right, you'll just create a login and password. It's super simple, quick and easy.
[CUSTOMER][POSITIVE] OK. OK and it's super simple. Thank thank you thank you so much [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] My pleasure.
[CUSTOMER][NEUTRAL] Uh, let me create that one. OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm. OK. Uh, and it
[CUSTOMER][NEUTRAL] OK. I think I have created my account now.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And so then when you log in you're just gonna go in and put there's a.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So then when again you're just gonna go in and put.
[AGENT][POSITIVE] A quick option, quick access?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Uh, yes, yes, uh, the APL claim number, the patient's first name, correct?
[AGENT][NEUTRAL] But
[AGENT][POSITIVE] That's right.
[CUSTOMER][POSITIVE] That's right. Thank you.
[AGENT][NEUTRAL] And date of birth, I think it asks for date of birth as well.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you so much.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, I think I got that you'll be here and thank you so much for your assistance.
[AGENT][POSITIVE] That that's a lot faster than faxing, isn't it?
[CUSTOMER][POSITIVE] Thank you, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] You're welcome, [PII]. Now listen.
[CUSTOMER][NEUTRAL] And may I get the call reference number?
[AGENT][NEUTRAL] Yeah, so with that portal you now have 24/7 access to claim status. You have access to EOBs and you can submit claim documents online as well.
[CUSTOMER][NEUTRAL] Oh yes, sure.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Oh thank you. Thank you so much for your assistance.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] It's been my pleasure. Is there anything else I can help you with, [PII]?
[CUSTOMER][NEUTRAL] Uh, that's all for this claim, [PII]. May I get the call reference number?
[AGENT][NEUTRAL] A call reference number is my name and today's date, and I spell my name [PII].
[CUSTOMER][NEUTRAL] Oh my number is my name.
[CUSTOMER][POSITIVE] Right. Mhm. Mhm. And the last name [PII]. Thank you, [PII], and thank you so much for your assistance. Have a great day and take care. Bye bye.
[AGENT][POSITIVE] Thank you for calling APO. You have a wonderful day as well. Take care. Bye-bye.
[CUSTOMER][POSITIVE] Thank you and thank you. You have a wonderful day as well. Thank you. Bye bye bye.