AccountId: 011433970860
ContactId: 50840067-48e9-45ce-af52-2af9db6d67de
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 793700 ms
Total Talk Time (AGENT): 203210 ms
Total Talk Time (CUSTOMER): 229355 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/50840067-48e9-45ce-af52-2af9db6d67de_20250110T16:31_UTC.wav
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[AGENT][POSITIVE] Good Morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII].
[CUSTOMER][NEUTRAL] My name is [PII] I M.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Last initial is [PII]
[CUSTOMER][NEUTRAL] Calling from Nicola Children's Pediatrics. I'm here for claim status.
[AGENT][POSITIVE] Hey man, sure it would be my pleasure to, I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] Call
[CUSTOMER][NEUTRAL] Yes, yes, and my callback number is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the patient's policy number?
[CUSTOMER][NEUTRAL] 023.
[CUSTOMER][NEUTRAL] 130
[CUSTOMER][NEUTRAL] 39 M as in Mike L as in Lima 8.
[AGENT][POSITIVE] Thank you, [PII], and it would be a pleasure to help you with claim status today. What is the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Name name is [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And I can help you with that claim status. Do you have a claim number or date of service?
[CUSTOMER][NEUTRAL] No, no, I don't have that UV. Uh, actually, I have that claim status. Just I need UB from you. Previously, I just called on [PII], sorry, uh, previously I just called on, uh, [PII] for uh EOB but didn't receive yet.
[AGENT][NEUTRAL] And what is the claim number?
[CUSTOMER][NEUTRAL] uh
[CUSTOMER][NEUTRAL] Uh, I don't have that claim number actually. Just I need, uh, uh, just I need the claim was received on [PII], processed on [PII], and the it denied for office visit is not covered for the patient.
[AGENT][NEUTRAL] OK, what's the
[CUSTOMER][NEUTRAL] Just I need UB from you.
[AGENT][NEUTRAL] What's the date of service?
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] [PII], uh, date of services [PII].
[CUSTOMER][NEUTRAL] Well the amount is 354.42 cents.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And what is it you said Nicholas Children's Hospital?
[CUSTOMER][NEUTRAL] Child's pediatrics.
[AGENT][NEUTRAL] Pediatric, gotcha.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Have you set up the online portal for providers you can get that EOB instantly online.
[CUSTOMER][NEGATIVE] Uh, I, I'm unable to open my account. That's why I just called you for sending that EOB.
[AGENT][NEUTRAL] OK, do you have an active account? because I might can help you get in.
[CUSTOMER][NEUTRAL] No, no, please, uh please, uh, you can uh send it over to me through fax.
[AGENT][NEUTRAL] OK, it's gonna take me just a minute, so bear with me.
[AGENT][NEUTRAL] Can you spell your name for documentation, please?
[CUSTOMER][NEUTRAL] [PII] I M.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] If you'll give me just one moment and then I'll come back and get that fax number one moment please.
[AGENT][POSITIVE] Yeah, if you ever have a chance to open up that account on the portal, it's a lot quicker getting that EOB.
[AGENT][NEUTRAL] And you also have 24/7 access to the EOBs and claim status as well as claim submission.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] You want the claim number, Himanshu?
[CUSTOMER][NEUTRAL] Yes, please provide me the claim number.
[AGENT][NEUTRAL] The claim number is 341.
[AGENT][NEUTRAL] 81
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] 21
[AGENT][NEUTRAL] And I'm ready for that fax number, Himanshu.
[CUSTOMER][NEUTRAL] 513
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 964
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 6247.
[AGENT][NEUTRAL] Just to verify that fax number I'm sending this to is [PII].
[CUSTOMER][NEUTRAL] Yeah and please uh write this fax number in your notes because I have 2 more accounts regarding the same that I need you'll be from 2 accounts.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh this fax number will be the same.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Bear with me just one moment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mm.
[AGENT][POSITIVE] Alright, and on that EOB is on the way for you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And did you say that um you had more claims for the same patient or different patients?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Is it for the same patient or different patient?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Different patient
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] I I sure I'm ready for that next policy number whenever you are.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Just a second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Next member is different.
[AGENT][POSITIVE] OK, I'm ready.
[CUSTOMER][NEUTRAL] Sorry, member is same.
[CUSTOMER][NEUTRAL] Member is same.
[AGENT][NEUTRAL] For [PII]
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK, and that data service?
[CUSTOMER][NEUTRAL] Yeah so this is [PII].
[AGENT][NEUTRAL] What is the bill amount?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 354. 42 cents.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, let me give you that claim number and then I'll, I'm working on that fax so.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] You ready for the claim number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Claim number 342-9238.
[AGENT][NEUTRAL] And then if you'll bear with me while I get this facts prepared.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] OK, that EOB is on the way for you.
[CUSTOMER][NEUTRAL] OK, moving to the next one.
[AGENT][NEUTRAL] Is it a is it a different policy?
[CUSTOMER][NEUTRAL] Just a second.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Member is different.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And that policy number?
[CUSTOMER][NEUTRAL] Just a second.
[CUSTOMER][NEUTRAL] What you.
[CUSTOMER][NEUTRAL] 00 sorry member's ID is 022.
[CUSTOMER][NEUTRAL] 165
[CUSTOMER][NEUTRAL] 15
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that name and date of birth?
[CUSTOMER][NEUTRAL] Name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] And that data service.
[CUSTOMER][NEUTRAL] Mhm. [PII] bill amount is 354. 42 cents.
[AGENT][NEGATIVE] Looks like we received that claim twice. Do you want the most recent EOB or the original? It's denied for the the same way.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I want that UV uh which I received in [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] If you have the latest one you can provide me that.
[AGENT][NEUTRAL] That is in fact.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] The latest one.
[CUSTOMER][NEUTRAL] OK. Uh, please hold on the claim number.
[AGENT][NEUTRAL] It's the 354-626-1.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But you know
[AGENT][NEUTRAL] And bear with me just one moment.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] Yeah, with the portal you would have already had all three EOBs.
[AGENT][NEUTRAL] So y'all might if if you're interested, you might want to mention getting that portal.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] But
[AGENT][POSITIVE] It's super easy. It's a self registration.
[CUSTOMER][NEUTRAL] We are
[CUSTOMER][NEUTRAL] Hm
[AGENT][NEUTRAL] And it just downloads the ELBs immediately. Just trying to help you out, and are you.
[CUSTOMER][NEUTRAL] OK, OK. Uh.
[CUSTOMER][NEUTRAL] Yeah, yeah. Mhm.
[CUSTOMER][NEUTRAL] Uh, so you, you have sent it?
[AGENT][POSITIVE] No, I have not yet. I'm getting it prepared.
[CUSTOMER][NEUTRAL] OK. How about your call reference number?
[AGENT][NEUTRAL] The call reference number is my name and today's date, and I spell my name [PII]
[AGENT][NEUTRAL] First initial last name, [PII], and if you'll continue to hold just one moment while I.
[AGENT][POSITIVE] Take care of this EOB for you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEGATIVE] If you're bullying.
[AGENT][NEUTRAL] Alright, [PII] that EOB is on the way. Is there anything else I can help you with today?
[AGENT][NEUTRAL] [PII]