AccountId: 011433970860
ContactId: 262382d3-2157-4422-abca-9a8462fbb3d1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 174500 ms
Total Talk Time (AGENT): 71313 ms
Total Talk Time (CUSTOMER): 59101 ms
Interruptions: 0
Overall Sentiment: AGENT=2.7, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/262382d3-2157-4422-abca-9a8462fbb3d1_20250130T14:12_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] Hi [PII], my name is [PII]. I'm calling on behalf of Nicholas Children's Hospital. I'm trying to check a claim status, please.
[AGENT][POSITIVE] OK, well, I'll be more than happy to assist you with the claim status. And may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII] and that's a direct line.
[AGENT][POSITIVE] Thank you for that. And just for my notes, can you spell your first name for me, please?
[CUSTOMER][NEUTRAL] Yes, it is [PII]
[AGENT][NEUTRAL] And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yes it is.
[CUSTOMER][NEUTRAL] 254-498-6
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Here we go. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII], uh, date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service for the claim you want me to check on?
[CUSTOMER][NEUTRAL] Yes, it's [PII] through [PII].
[AGENT][NEUTRAL] And the total bill amount?
[CUSTOMER][NEUTRAL] Uh, $52,536.63.
[AGENT][NEUTRAL] Here we go.
[AGENT][NEUTRAL] And you said you're calling from [PII], right?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so I'm just pulling up the claim. Hold on one moment. 696.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, so I'm showing the claim was received on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The claim number is 3551696.
[AGENT][NEUTRAL] And on [PII], the claim was denied requesting the explanation of benefits from um primary insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And just to verify your fax number is [PII].
[AGENT][POSITIVE] Yes, ma'am, that's correct.
[CUSTOMER][NEUTRAL] OK, and it's attention to claims, right?
[AGENT][NEUTRAL] Mhm. APL claims department.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] And [PII] was
[CUSTOMER][POSITIVE] Uh thank you for helping me today.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can help you with today?
[CUSTOMER][POSITIVE] Um, no, I think that's it. Thank you so much.
[AGENT][POSITIVE] You're welcome and thanks for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] You too thank you so much bye bye.
[AGENT][POSITIVE] You're welcome. Bye bye.