AccountId: 011433970860
ContactId: 524fe86d-da56-40be-a564-3cf0bb70922a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 638940 ms
Total Talk Time (AGENT): 134674 ms
Total Talk Time (CUSTOMER): 108867 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=-0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/524fe86d-da56-40be-a564-3cf0bb70922a_20250221T16:12_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This 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 if you could help me with those.
[AGENT][NEUTRAL] OK, Miss [PII], I can help you. Can you please give me your callback number?
[CUSTOMER][NEUTRAL] I can, it's [PII].
[AGENT][NEUTRAL] Thank you. And then what's the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Um, [PII]. Date of birth is.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the policy number is 02509836.
[AGENT][NEUTRAL] OK, let me look up that policy number real quick.
[AGENT][NEUTRAL] OK and then what is the data service?
[CUSTOMER][NEUTRAL] It is 1029 of 24 and the bill amount would be 24,178.
[CUSTOMER][NEUTRAL] 98.
[AGENT][NEUTRAL] Thank you. And then what is the charge amount after the primary insurance paid their part?
[CUSTOMER][POSITIVE] Thank.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Um, looks like it would be.
[CUSTOMER][NEUTRAL] 1500.
[CUSTOMER][NEUTRAL] Even.
[AGENT][NEUTRAL] OK, alright, I'm gonna put you on a brief hold, Miss [PII], while I pull this claim in for us and I'll be right back.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] You are
[AGENT][NEUTRAL] Thank you for holding for me, Ms. [PII]. I did find the claim. The claim number is 3,556,070.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] The claim was I'm sorry, was paid $1500 with check number 2024665.
[AGENT][NEUTRAL] And let me get you the date.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It was paid on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] All right, um, I will check more into that one on our end, um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I just have one more claim for a different member.
[AGENT][NEUTRAL] OK, alright, let me get where I need to be right, what is that member's name?
[AGENT][NEUTRAL] Date of birth and policy number?
[CUSTOMER][NEUTRAL] 6
[CUSTOMER][NEUTRAL] OK, it is [PII]. Date of birth is [PII] and that policy number is 02330548.
[AGENT][NEUTRAL] OK, let me pull in that policy real quick.
[AGENT][NEUTRAL] OK, and then what is the date of service, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the charge amount
[CUSTOMER][NEUTRAL] Charge amount for that one is $942.16.
[AGENT][NEUTRAL] OK, and then the charge amount after the primary paid their part?
[CUSTOMER][NEUTRAL] OK. Looks like.
[CUSTOMER][NEUTRAL] $200.
[AGENT][NEUTRAL] OK. And is it still with Nicholas Children's Hospital?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, alright, I'm gonna put you on hold again. I'm gonna look this one up for us and I'll be right back.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] 2
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] OK Miss [PII], this is [PII] back with you again. So looking on Susan's uh for data service for [PII], it was the claim was filed on a different policy number uh the correct policy number is 248.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 1566.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the claim was denied because we need the explanation of benefits from the primary insurance carrier.
[AGENT][NEUTRAL] And the claim number is 345-08887.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I will get that primary ELB faxed over and I'll update that policy number as well in our system. I thank you for that.
[AGENT][POSITIVE] You're very welcome.
[CUSTOMER][NEUTRAL] And I think that's all I need today, um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I thank you for your help and I hope you have a good weekend.
[AGENT][POSITIVE] You too, Ms. [PII] you have a blessed one. Thanks for calling APL.
[CUSTOMER][POSITIVE] You too thank you bye bye.
[AGENT][NEUTRAL] Bye-bye, ma'am.