AccountId: 011433970860
ContactId: 3c707fe6-e48f-4da9-93b1-0082b7243d81
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1268060 ms
Total Talk Time (AGENT): 158823 ms
Total Talk Time (CUSTOMER): 185768 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=-1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/3c707fe6-e48f-4da9-93b1-0082b7243d81_20250206T19:52_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is So. How may I assist you?
[CUSTOMER][NEUTRAL] Yeah, hi, my name is [PII] and I'm calling on behalf of Pro office and looking for a claim status.
[AGENT][NEUTRAL] Sure, I can assist you with claim status, Mr. [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure. [PII].
[AGENT][POSITIVE] Thank you. And may I have um where are you calling from?
[CUSTOMER][NEUTRAL] Uh, Nicholas Children's Hospital.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] 01482796.
[CUSTOMER][NEUTRAL] ML 8.
[AGENT][NEUTRAL] Mm.
[AGENT][POSITIVE] Thank you. One moment.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] So, and the member's name is.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] [PII] [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] OK, and what is um the date of service and the amount of the claim?
[CUSTOMER][POSITIVE] On the top services.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] May I know your name? What is your name?
[AGENT][NEUTRAL] My name is [PII]. That's [PII], last initial [PII]. And may I have the amount of the claim, Mr. [PII]?
[CUSTOMER][POSITIVE] Thank you so
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] $2,602.86.
[AGENT][POSITIVE] OK. Thank you.
[AGENT][NEUTRAL] And again that was [PII], correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Alright.
[AGENT][NEUTRAL] OK, um, we received the claim [PII], processed [PII], and it looks like we're needing the explanation of benefits from the primary insurance to continue the processing of this claim.
[CUSTOMER][NEUTRAL] Uh, required primary UV correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Thank you. Uh, and the reference number is?
[AGENT][NEUTRAL] My name in today's date.
[CUSTOMER][NEUTRAL] Oh, sorry, sorry.
[CUSTOMER][NEUTRAL] Uh, may I know the, uh, first of all, may I know the, uh, claim number?
[AGENT][NEUTRAL] 3,541,840.
[CUSTOMER][NEUTRAL] Sorry, uh, could you please spell it, uh, could you please, uh, spoke up again?
[AGENT][NEUTRAL] 3
[AGENT][NEUTRAL] It's 3,541,840.
[CUSTOMER][POSITIVE] Thank you. OK, let's move for another glimpse zone.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] OK, bear with me, I have to make a note.
[CUSTOMER][NEUTRAL] And the uh and the.
[CUSTOMER][NEUTRAL] Pro office is same NPI is same.
[CUSTOMER][NEUTRAL] Can I speak?
[AGENT][NEUTRAL] Um, no, sir. I'm making the note.
[CUSTOMER][POSITIVE] OK, take your time, take your time.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. What's the next policy number?
[CUSTOMER][NEUTRAL] 02494804 ML 8.
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] And the patient name is [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] What's the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] They took.
[CUSTOMER][NEUTRAL] Date of service is [PII]. Total bill amount is $1,696.59.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] It.
[AGENT][NEUTRAL] All right, uh, this one we receive on [PII], process [PII], and we need the explanation of benefits.
[CUSTOMER][NEUTRAL] Then, uh, so.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] We received [PII], processed [PII].
[CUSTOMER][NEUTRAL] We don't.
[CUSTOMER][NEUTRAL] This
[AGENT][NEUTRAL] And we need the primary ERB.
[CUSTOMER][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] [PII]. May I know the claim number?
[AGENT][NEUTRAL] That is 354-7095.
[CUSTOMER][NEUTRAL] OK, let's go for another claim.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] What's the next policy number?
[CUSTOMER][NEUTRAL] The next policy number is.
[CUSTOMER][NEUTRAL] 60801.
[AGENT][NEUTRAL] That is not a policy number, that's the payer ID. Do you have a copy of the card?
[CUSTOMER][NEUTRAL] Wait a moment. Let me check the insurance card.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Could you please give me a couple of seconds?
[AGENT][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Thank you so much.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] OK, let's, uh, let's leave this claim. Uh, let's move for another claim.
[CUSTOMER][NEUTRAL] The member at age.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Wait a moment. Remember ID age?
[CUSTOMER][NEUTRAL] 02344570 [PII] [PII].
[AGENT][NEUTRAL] What yeah
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Patient name is [PII].
[AGENT][NEUTRAL] OK, and what's the date of birth?
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] What's the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] How much is the total charge?
[CUSTOMER][NEUTRAL] Total charge is $1,709.17.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Mm, let me check one more time.
[AGENT][NEUTRAL] And then that was [PII].
[CUSTOMER][NEUTRAL] Process on.
[AGENT][NEUTRAL] No, you said the date of service was [PII]?
[CUSTOMER][POSITIVE] Yes, yes, that is correct.
[AGENT][NEUTRAL] claim is not on file.
[CUSTOMER][NEUTRAL] Over.
[CUSTOMER][NEUTRAL] [PII] not on file.
[CUSTOMER][NEUTRAL] May I know the effective and termination date?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] As effective as um [PII].
[AGENT][NEUTRAL] And it terminated on.
[AGENT][NEUTRAL] See.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, this one terminated [PII]. Let me check and see if they have a different policy. One moment.
[AGENT][NEUTRAL] Mr. [PII], can you hold for me?
[CUSTOMER][NEUTRAL] Yes, yes, I can hear you.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello, are you there?
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.