AccountId: 011433970860
ContactId: 400095c1-46f8-404f-98b0-9f5b454ddc28
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 368510 ms
Total Talk Time (AGENT): 118349 ms
Total Talk Time (CUSTOMER): 155694 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/400095c1-46f8-404f-98b0-9f5b454ddc28_20250326T13:07_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling API. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, good morning. My name is Am. It's [PII], and I'm checking claim status.
[AGENT][NEUTRAL] OK, sure, I can ask a claim status, Mr. [PII]. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, callback number [PII].
[AGENT][NEUTRAL] OK. And may I have the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Nicholas Children's Hospital.
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah, policy number 02507921 M as in Mary, L as in Lima 7.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Patient name is [PII].
[CUSTOMER][NEUTRAL] And date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. May I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] A bit of service. It was for [PII].
[AGENT][NEUTRAL] OK, how much is the total charge?
[CUSTOMER][NEUTRAL] Uh, it was for just a moment, let me put it, yeah, it was for $569.09. 569.09.
[AGENT][NEUTRAL] Thank you. OK, let me see if I can find this claim for you. And for future, you can check claim status online through our website at [PII] and that's just optional.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh, for the website, I just want to confirm that like if we do not have the patient SSN number, like we won't be able to check the claim status, right? Actually, I do have the website, but I tried to check out to the web portal, but, you know, I was not able to verify the claim status. They're like, you know, they are asking for the uh patient SSN number, the last four digit number, but which we do not have for that.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, that's fine.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, that's fine, no problem. All right. Uh, so it looks like we received the claim [PII] and processed [PII], and we're still needing the explanation of benefits from the primary insurance to continue the processing of this claim.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So like the claim was denied for the primary you'll be right.
[AGENT][NEUTRAL] It is pending for primary EOB.
[CUSTOMER][NEUTRAL] Do you have the claim number, please?
[AGENT][NEUTRAL] Um, yes, the claim number is 352.
[AGENT][NEUTRAL] 0553.
[CUSTOMER][NEUTRAL] 352-055-3
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] And is there any fax number or the mailing address to submit the primary EP?
[AGENT][NEUTRAL] Yes, um, the fax number is [PII].
[AGENT][NEUTRAL] 3659423
[AGENT][NEUTRAL] The address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] this morning.
[CUSTOMER][NEUTRAL] OK. So uh just to confirm, uh, I got fax number here. It's [PII]. And the mailing address is [PII]. Is that right?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] And is there any attention that we need to put?
[AGENT][POSITIVE] Thanks department.
[CUSTOMER][NEUTRAL] Thank you. But is there any time frame to submit the uh primary you'll be.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So there's no time frame to submit prime video game.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] And before I ask for the call reference number, uh, I didn't get your name before. May I have your name one second please.
[AGENT][NEUTRAL] My name is [PII]. That's [PII]. That's initial [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so it's uh just [PII] and initial your last name [PII], right? Oh, got you. Thank you. Thank you so much for the information for helping me out, so I appreciate that. And do you have any reference number, please?
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Correct. Mhm.
[AGENT][NEUTRAL] We don't have reference numbers you can use my name in today's date.
[CUSTOMER][NEUTRAL] OK, just your names and they take, that would be fine, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] All right, Ms. So, yeah, thank you so much. I appreciate it. Thank you.
[AGENT][POSITIVE] You're welcome. Thank you for calling EPL. Have a good day.
[CUSTOMER][POSITIVE] Thank you. Have a good one. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.