AccountId: 011433970860
ContactId: 415fd7e8-5be9-4ca2-aec0-7106d60377b4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 426790 ms
Total Talk Time (AGENT): 118122 ms
Total Talk Time (CUSTOMER): 131300 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/415fd7e8-5be9-4ca2-aec0-7106d60377b4_20250624T16:37_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, this is [PII], and I'm calling from Nicholas Children's Hospital looking for a claim status for 2 patients.
[AGENT][NEUTRAL] Sure, [PII], I can assist you with claim status. Um first, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, the callback number will be [PII].
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] The policy number will be 02329708ML8.
[AGENT][NEUTRAL] Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] The patient name is [PII] and the date of birth for the patient is, just give me a second, it is [PII].
[AGENT][NEUTRAL] Thank you. Now I need the date of service and bill charges.
[CUSTOMER][NEUTRAL] Uh, the date of service is [PII] and the bill charges are $1,094.92.
[AGENT][NEUTRAL] OK, yes, we received that claim on [PII].
[AGENT][NEUTRAL] The claim processed on [PII].
[AGENT][NEUTRAL] The claim number is 3559068.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this claim is deigning because we need the EOB from the primary insurance company.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, just allow me a second.
[CUSTOMER][NEUTRAL] The claim number is 3559068.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEGATIVE] However, I am just checking this claim on the uh provider portal of your, uh, for American public life and I'm unable to find the claim.
[AGENT][NEUTRAL] OK, I apologize. Yeah, the claim is on file. I'm showing it here on our portal. Do you need the EOB? Do you need me to fax it to you?
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][POSITIVE] If you can it that would be very much helpful.
[AGENT][NEUTRAL] OK. What's your fax number?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] OK, so that's attention [PII] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Sure
[CUSTOMER][NEUTRAL] that
[AGENT][NEUTRAL] OK. You should receive the EOB in about 10 minutes and you said that you have another claim?
[CUSTOMER][NEUTRAL] Yeah, there's one more patient.
[AGENT][NEUTRAL] OK. And I'm ready for that policy number.
[CUSTOMER][NEUTRAL] It is 02430725 ML 8.
[AGENT][NEUTRAL] Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Patient name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] And the date of service and bill charges on the claim, please.
[CUSTOMER][NEUTRAL] Date of service is the date range is starting from [PII] and the total bill charges on the claim is.
[CUSTOMER][NEUTRAL] $4,507.57.
[AGENT][NEUTRAL] And please repeat the date of service.
[CUSTOMER][NEUTRAL] Uh, date of service uh is uh [PII].
[AGENT][NEUTRAL] OK. I'm not showing that claim on file. Um, would you like to verify how it was submitted?
[CUSTOMER][NEUTRAL] Yeah, it was submitted.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] It was submitted electronically on [PII].
[AGENT][NEUTRAL] OK. And what pair ID was used?
[CUSTOMER][NEUTRAL] The payer ID used was 60801.
[AGENT][NEUTRAL] OK, yeah, that's the correct payer ID um claims can also be faxed in if you would like to fax it, and there's no timely filing limit.
[CUSTOMER][NEUTRAL] OK. Can you provide me the fax number?
[AGENT][NEUTRAL] Um, yes, the fax number is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] 942-3 and please attention it to the claims department.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, in that case, that would be all. Lastly, can you provide me the reference number?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. My name is [PII], um it's spelled [PII] Last initial is [PII] and today's date. Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] No, that would be all.
[AGENT][POSITIVE] OK. Well, I thank you [PII] for calling APL. You have a great day. Mm bye.
[CUSTOMER][NEUTRAL] Yeah bye.