AccountId: 011433970860
ContactId: 19ac2f25-e5b1-4ce3-99c1-76162431aaea
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 820719 ms
Total Talk Time (AGENT): 175457 ms
Total Talk Time (CUSTOMER): 151338 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/2025/03/10/19ac2f25-e5b1-4ce3-99c1-76162431aaea_20250310T19:19_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. Last initial [PII]. Could you please help me with the claim?
[AGENT][NEUTRAL] Sure, I can assist you with claims. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. Can you repeat that first digit one more time?
[CUSTOMER][NEUTRAL] Sure. [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you. And may I have the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Nicholas Children's Hospital.
[AGENT][NEUTRAL] OK, and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Sure
[CUSTOMER][NEUTRAL] Policy ID is
[CUSTOMER][NEUTRAL] 020
[CUSTOMER][NEUTRAL] 06254.
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Member's name [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] for them
[AGENT][NEUTRAL] Mhm. All right. And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] D of service is [PII]. And the bill amount is $19,526.51.
[AGENT][NEUTRAL] OK, OK, let me see if I can find this claim for you and for the future, you can check claim status online through our website at [PII], and that's just optional and.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] OK, so it looks like we received the claim on [PII].
[AGENT][NEUTRAL] And we process [PII] and we're needing the explanation of benefits from the primary insurance to continue the processing of this claim.
[CUSTOMER][NEUTRAL] What's the claim number?
[AGENT][NEUTRAL] That is 355-4465.
[CUSTOMER][POSITIVE] OK. Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] I have a few more claims.
[CUSTOMER][NEUTRAL] Uh, for a different number, could you please also?
[AGENT][NEUTRAL] Registered member?
[AGENT][NEUTRAL] OK, one moment, let me go ahead and make a note on this one.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, what's the next policy number?
[CUSTOMER][NEUTRAL] Next part is ID 014.
[CUSTOMER][NEUTRAL] 80503.
[AGENT][NEUTRAL] What's the name and date of birth of this patient?
[CUSTOMER][NEUTRAL] Member's name, [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the total charge amount is $3,656.96.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] We received the claim [PII], processed [PII]. We need the primary EOB.
[CUSTOMER][NEUTRAL] And what is the claim number for this one?
[AGENT][NEUTRAL] Name number is 355.
[AGENT][NEUTRAL] 4196.
[CUSTOMER][POSITIVE] OK. Thank you for this one also.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me make a note.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, go ahead with the next one.
[CUSTOMER][NEUTRAL] Member ID 165.
[CUSTOMER][NEUTRAL] 956-63.
[CUSTOMER][NEUTRAL] the gap
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] My name is [PII]. Date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Date of service, [PII].
[CUSTOMER][NEUTRAL] Total charge amount is $1,391.15.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That was [PII], correct?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] All right, so it looks like we have uh received the claim on [PII] passes [PII] and it's missing the primary EOB.
[CUSTOMER][NEUTRAL] OK. And what is the claim number for this claim?
[AGENT][NEUTRAL] It's 3553961.
[CUSTOMER][NEUTRAL] OK. Shall we move to the last one?
[AGENT][NEUTRAL] Bear with me, let me make a note on this one.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, what's the next one.
[CUSTOMER][NEUTRAL] It is 014.
[CUSTOMER][NEUTRAL] 82796.
[AGENT][NEUTRAL] What's the name and date of birth?
[CUSTOMER][NEUTRAL] Member's name is [PII].
[CUSTOMER][NEUTRAL] Wait a minute. It is [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] OK, what's the date of service and the amount of the time.
[CUSTOMER][NEUTRAL] Date of service, [PII].
[CUSTOMER][NEUTRAL] And the total charge amount is uh $17.23. And actually, it was a corrected claim which was submitted with primary UV. So I just want to confirm that, have you received this UV or not?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Uh 92024.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Looks like we still didn't receive that. Bear with me just a second. Let me pull the claim again.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, we have not received the claim. So we, um, the EOB, I'm sorry, the EOB, um, it looks like we received a second submission on [PII], and we processed on [PII], but still the EOB is not attached to the claim.
[CUSTOMER][NEUTRAL] OK. And what is the claim number for this one?
[AGENT][NEUTRAL] OK, that is 3559491.
[CUSTOMER][POSITIVE] OK. Thank you. Thank you for your help.
[AGENT][POSITIVE] You're welcome. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, thank you.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good day.