AccountId: 011433970860
ContactId: 26e4f020-cce0-429e-be3a-a74b277ee6f2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 229089 ms
Total Talk Time (AGENT): 99383 ms
Total Talk Time (CUSTOMER): 50547 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=2.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/26e4f020-cce0-429e-be3a-a74b277ee6f2_20250214T15:38_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling on behalf of Nicholas Children's Hospital to check a claim status, please.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, [PII], you have one claim to direct status on, is that correct?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][POSITIVE] Yes, ma'am, I can help you with that. And [PII], what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and the member's policy number please, [PII]?
[CUSTOMER][NEUTRAL] 02556458.
[AGENT][POSITIVE] Thank you one moment.
[AGENT][NEUTRAL] And any information that I provide for you today, [PII] would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII], date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Just one moment.
[AGENT][NEUTRAL] And what is the date of service and total bill amount for him, please?
[CUSTOMER][NEUTRAL] [PII] 24 through [PII] of 24 and the bill amount is $89,114.55.
[AGENT][NEUTRAL] I'm sorry, did you say 0.55 or 85?
[CUSTOMER][NEUTRAL] 55.
[AGENT][NEUTRAL] 55. OK, thank you. One moment.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK. So I do show that this claim, one second, I'm so sorry. One moment.
[AGENT][NEUTRAL] OK, so I do show that this claim was received [PII] on [PII] and it was processed on [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The claim number is 355.
[CUSTOMER][NEUTRAL] Right
[AGENT][NEUTRAL] 9673.
[AGENT][NEUTRAL] And this claim was denied and the reason for the denial, [PII], is that we need a copy of the primary insurance company's explanation of benefits.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] And I do have the fax number and everything, so I will get that faxed over to you all today.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK and then um one last thing, do you also have our portal website, [PII] that once we process the claim you should be able to check claim status by going to [PII].
[CUSTOMER][NEUTRAL] Um, yes.
[AGENT][NEUTRAL] The [PII]?
[CUSTOMER][POSITIVE] Yes, I do.
[AGENT][NEUTRAL] OK, good. All right. Well, is there anything else that I can help you with this morning?
[CUSTOMER][POSITIVE] Um, no, I think that's it, and I appreciate your help today.
[AGENT][POSITIVE] Well, you are certainly very welcome and thank you again for calling APL. I hope you have a wonderful weekend.
[CUSTOMER][POSITIVE] You too. Thank you so much.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Bye bye.