AccountId: 011433970860
ContactId: fdb5adb5-7c68-4f34-b742-592a3f66d118
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 397019 ms
Total Talk Time (AGENT): 118117 ms
Total Talk Time (CUSTOMER): 70268 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/fdb5adb5-7c68-4f34-b742-592a3f66d118_20250228T18:59_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. My name is [PII] and I'm trying to get a claim status update, please.
[AGENT][NEUTRAL] OK, Miss [PII], I can help you with claim status. May I get your call back number and the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Yes, it's gonna be for Prisma Health Urgent Care, South Carolina.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And then what is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, ma'am. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Patient's policy number is gonna be.
[CUSTOMER][NEUTRAL] 02362911 and that's for [PII]. Date of birth [PII].
[AGENT][NEUTRAL] OK, let me pull in that policy real quick.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, and then what is the data service for [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the charge amount?
[CUSTOMER][NEUTRAL] She has two billed amounts. The first one is $238.03.
[CUSTOMER][NEUTRAL] And then the second one is $171.
[AGENT][NEUTRAL] OK, and is the second one for the same data service?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I look up this claim for you and I'll be right back.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, thank you for holding for me, Miss [PII]. So looking at both of these claims, first claim number is 3556299.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] A second claim number is 3562641.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] We're waiting for eligibility from benefits and a card for this member for this week of service data service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. And what was the receiving receipt date?
[AGENT][NEUTRAL] Yes, ma'am. Let me look that up real quick.
[AGENT][NEUTRAL] OK, the first claim, the 355-6299 was received on [PII] and processed on [PII].
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And then the second one.
[AGENT][NEUTRAL] Was received on [PII] and processed also on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] How long should we allow for these to
[CUSTOMER][NEUTRAL] For a possible resolution.
[AGENT][NEUTRAL] Um, the claims department checks the checks the eligibility daily.
[AGENT][NEUTRAL] And once the patient is eligible then they reop process the claim automatically.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right. Um.
[CUSTOMER][NEUTRAL] So was it sent over to them now to check the eligibility?
[CUSTOMER][NEUTRAL] Or
[AGENT][NEUTRAL] Right, as of right now, the, the claim is still standing as we're waiting on eligibility from benefits and a card.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK, and is there a reference number I can notate for our call today?
[AGENT][NEUTRAL] Yes, ma'am. You can use my name [PII] in today's date.
[CUSTOMER][POSITIVE] OK. Thank you very much. I appreciate it.
[AGENT][NEUTRAL] Uh
[AGENT][POSITIVE] We appreciate you Miss [PII]. I hope you have a good weekend and thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you. You as well. Bye-bye.
[AGENT][NEUTRAL] Mm bye bye now.