AccountId: 011433970860
ContactId: 3f4cd640-416a-4f81-8227-14b2ea350e5d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 300220 ms
Total Talk Time (AGENT): 134650 ms
Total Talk Time (CUSTOMER): 76866 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/3f4cd640-416a-4f81-8227-14b2ea350e5d_20250131T13:47_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you, good morning. Thank you for calling ATL. 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 have two claims here to check the status of if I could.
[AGENT][POSITIVE] Sure, and [PII], I'll be more than happy to help you with the claim status. May I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have, is it the same person or two different policies?
[CUSTOMER][NEUTRAL] Uh, it's two different policies.
[AGENT][NEUTRAL] OK. May I have the first member's policy number?
[CUSTOMER][NEUTRAL] Yes, it's 0243.
[CUSTOMER][NEUTRAL] 0725 M as in Mike L as in Lima 8
[AGENT][NEUTRAL] Thank you for that. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. 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] Uh, [PII].
[AGENT][NEUTRAL] And the total bill amount?
[CUSTOMER][NEUTRAL] It is $832.85.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 72. OK, so I'm showing that we received the claim on [PII].
[AGENT][NEUTRAL] That claim number is 354.
[AGENT][NEUTRAL] 8672.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And on [PII], the claim was denied requesting the explanation of benefits from primary insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, I don't see that that was sent over at all, so I will fax that over here in a little while.
[AGENT][NEUTRAL] OK, did you need the fax number or you're OK?
[CUSTOMER][NEUTRAL] Um, just to verify it's [PII] correct?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and the next member's policy number?
[CUSTOMER][NEUTRAL] The next one is 243-072-5.
[AGENT][NEUTRAL] Oh, wait a minute. OK, is it a different member?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, wait, then let me not put these notes. Hold on one second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And which member is it for the second claim?
[CUSTOMER][NEUTRAL] Um, for the, the member's name.
[AGENT][NEUTRAL] Mhm, because it's the same policy number, um.
[AGENT][NEUTRAL] It might be a different family member I guess, because that policy number is the same as [PII]'s.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Uh, it's [PII].
[AGENT][NEUTRAL] OK. Let me see who is, here we go. And um his date of birth?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] Alrighty, and the um data of service for the claim and the total bill.
[CUSTOMER][NEUTRAL] 1023 24, and $832.85.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] 3
[AGENT][NEUTRAL] OK, so it's the same denial reason, but I'm gonna give you the claim number when we received it.
[AGENT][NEUTRAL] Um, so I received it on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, the claim number is 354-835-5.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And on [PII], the claim was denied um requesting the explanation of benefits from primary.
[CUSTOMER][NEUTRAL] Alright, I'll get that one faxed over as well um.
[AGENT][NEUTRAL] All right, [PII], was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Uh, that's it, just a reference number for the call.
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. Um, so that's [PII] to my last name is [PII], and then today's date.
[CUSTOMER][POSITIVE] Alright thank you so much for your help today.
[AGENT][POSITIVE] You're welcome, [PII], and thanks for calling APL. I hope you have a great weekend.
[CUSTOMER][POSITIVE] You too thank you so much bye bye.
[AGENT][POSITIVE] You're welcome. Bye bye.