AccountId: 011433970860
ContactId: 3e08b079-bc38-4e22-bdb9-247ae8f48a6b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 269359 ms
Total Talk Time (AGENT): 113149 ms
Total Talk Time (CUSTOMER): 49983 ms
Interruptions: 1
Overall Sentiment: AGENT=1.5, CUSTOMER=2.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/27/3e08b079-bc38-4e22-bdb9-247ae8f48a6b_20250227T13:11_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APO. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, yes, hi, good morning, [PII]. My name is [PII]. I'm calling from Nicholas Children's Hospital following up on a claim.
[AGENT][NEUTRAL] OK, [PII], you have one claim to check status on, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[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 now, please, [PII].
[CUSTOMER][NEUTRAL] 241-936-8
[AGENT][NEUTRAL] 241-936-8. Is that correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] Thank you. One moment please.
[AGENT][NEUTRAL] And [PII], any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] This is for [PII], [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what is the data service and total bill amount for him, please?
[CUSTOMER][NEUTRAL] Uh, yes, this is for [PII] for $9880.08.
[AGENT][NEUTRAL] OK, so that was 22 through 228, is that correct?
[CUSTOMER][POSITIVE] That is correct.
[AGENT][NEUTRAL] For $9880.08.
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] With me, just one moment, please.
[CUSTOMER][POSITIVE] No problem.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so saved on 2:10 on 22.
[AGENT][NEUTRAL] Hm, hold on, let me, I'm so sorry. That is correct. 2-10-2025 and processed and denied on 212, 2025.
[AGENT][NEUTRAL] The claim number is going to be 3562848.
[AGENT][NEUTRAL] And the reason for the denial is that we are in need of the primary insurance company's explanation of benefits.
[CUSTOMER][NEUTRAL] OK, I just wanted to make sure. OK, could I get a reference number for this call?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Sure, you would uh use my name along with today's date and then [PII], once that has been received and we have processed the claim, we do have a portal that you should also be able to check claim status in by going to [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect. Thank you so much for your help today, [PII]. I hope you have a wonderful rest of your day.
[AGENT][POSITIVE] OK. Well, you are. Yes, ma'am, [PII], I hope you do too, and thank you so much again for calling APL.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] Uh-huh, bye bye.