AccountId: 011433970860
ContactId: ff48524e-675e-401a-a7f3-ecdb387dd73d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 211899 ms
Total Talk Time (AGENT): 111208 ms
Total Talk Time (CUSTOMER): 70923 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/ff48524e-675e-401a-a7f3-ecdb387dd73d_20250203T18:44_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from Prisma Health at Coney Memorial Hospital, and I'm trying to get claim status.
[AGENT][NEUTRAL] OK, yeah, I can check on a claim for you. Uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Um, I have 02560299.
[AGENT][NEUTRAL] OK, thank you. And uh what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Uh, [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that [PII]. uh, what was the date of service for this claim?
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[AGENT][NEUTRAL] [PII]. OK, one moment.
[AGENT][NEUTRAL] And what was that bill amount?
[CUSTOMER][NEUTRAL] $1,166 even.
[AGENT][POSITIVE] Got it thank you one moment.
[AGENT][NEUTRAL] OK, so we did receive this claim. [PII] looks like we are missing a copy of the primary EOB.
[CUSTOMER][NEUTRAL] OK, primary ELB let's see here.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, um,
[CUSTOMER][NEUTRAL] Yeah, this, this number only has Medicaid secondary and
[AGENT][NEUTRAL] Oh, OK, so this policy, OK, so this policy is a secondary medical policy, um, and it does go off of major medical, so that would be, you know, of course, Blue Cross, Aetna, Cigna.
[CUSTOMER][NEUTRAL] Medicated.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Insurances like that.
[AGENT][NEUTRAL] And so we would need that EOB before we can process these claims.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, but this is like the, the only other insurance besides Medicaid and Medicaid is always gonna be secondary.
[AGENT][NEUTRAL] Right, I would get with them uh to see if they have any other, um, cause this one is dependent on major medical.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Got you. OK, so, um, can I have a
[AGENT][NEUTRAL] I can give you that claim number.
[CUSTOMER][NEUTRAL] Yeah, I was just about to ask that.
[AGENT][NEUTRAL] OK, yes, absolutely, um, it is 354-3560.
[AGENT][NEUTRAL] And if you'd like I can also
[CUSTOMER][NEUTRAL] And when did you guys see?
[AGENT][NEUTRAL] Sure, um, let's see, no, it's OK, uh, we received this claim [PII], and it was processed [PII].
[CUSTOMER][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you want me to send you a copy of the EOB?
[CUSTOMER][POSITIVE] That would be great. Are you able to fax it to me? OK.
[AGENT][NEUTRAL] Sure, yes ma'am. What's that fax number?
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and I would just put this to your attention?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, I will go ahead and get that sent to you now. You should get it here in maybe 10-15 minutes depending on how busy your machine is. Do you have any other questions for me?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, lastly, uh, can you provide me with the reference number for the call?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Sure, reference number would just be my first name, last initial, and today's date. Uh so my name is spelled [PII] last initial is A.
[CUSTOMER][POSITIVE] OK, got it. Thank you so much.
[AGENT][POSITIVE] Alright, yeah, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] You as well. Thank you. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.