AccountId: 011433970860
ContactId: 5ddd7306-7f9e-46d9-886c-b78f821f4b95
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 436250 ms
Total Talk Time (AGENT): 151281 ms
Total Talk Time (CUSTOMER): 140534 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/5ddd7306-7f9e-46d9-886c-b78f821f4b95_20250325T14:35_UTC.wav
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[AGENT][NEUTRAL] APL this [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes, my name is [PII], and I'm calling from Nicola Children's Hospital. I want to know the claim status of this member.
[AGENT][NEUTRAL] Sure, Lean, I can assist you with that. Can I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] Uh yeah. My callback number is [PII].
[AGENT][NEUTRAL] And what's the policy number of the member that you're inquiring claim status for today?
[CUSTOMER][NEUTRAL] Policy number is
[CUSTOMER][NEUTRAL] 01780474 M. Mary, L Lima 8.
[AGENT][NEUTRAL] Thank you. [PII], could you verify that patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, the patient name is [PII] and date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the date of service that you're calling about today?
[CUSTOMER][NEUTRAL] Uh, the date of service was on [PII].
[AGENT][NEUTRAL] [PII], I'm not showing the claim on file for the date of service, [PII].
[AGENT][NEUTRAL] You said [PII]. Is that the correct date or is it a?
[AGENT][NEUTRAL] Different date.
[CUSTOMER][NEUTRAL] Actually, the claim was the uh the, the primary, uh, there was a patient responsibility of 1,473.
[AGENT][NEUTRAL] What is the date of service?
[AGENT][NEUTRAL] You, you gave me [PII]. Is it [PII]?
[CUSTOMER][NEUTRAL] The date of service was
[CUSTOMER][NEUTRAL] [PII]. That is correct.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Was it for ER visit?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Uh, there, uh, there is a patient responsibility, uh, which is transferred to American Public, uh, Life Insurance. So I want to know the claim status of this one.
[AGENT][NEUTRAL] So was it for an ER visit, [PII]?
[CUSTOMER][NEUTRAL] I'm not sure about which visit it is.
[AGENT][NEUTRAL] What is the total bill amount before the patient responsibility because there's several claims for this date of service and I have to narrow it down to verify which one is your claim that you're calling about.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh, the amount is $4,765.78.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] This claim was received [PII]. It was processed [PII]. There was a payment of $1,473 made on this claim. Would you like that check number, [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Check number is 2,028,090.
[CUSTOMER][NEUTRAL] Is on which date?
[AGENT][NEUTRAL] Repeat your question.
[CUSTOMER][NEUTRAL] Uh, when was the issue?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Check that
[CUSTOMER][NEUTRAL] And may I have the claim number?
[AGENT][NEUTRAL] The claim number is 356-464-5. That's 356-464-5 and this check was cleared [PII]. Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] Uh, just give me a moment. [PII]. It was clear on [PII], right?
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] And uh when it was received, you said?
[CUSTOMER][NEUTRAL] The receiving date
[AGENT][NEUTRAL] The check this claim was received.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And may I, may I also have the processing date?
[AGENT][NEUTRAL] I gave you that the the date that the date that I gave you that the check was sent out was the date that the claim was processed.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And also, can you please uh text me that you will be for this month?
[AGENT][NEUTRAL] Sure, what is your fax number?
[CUSTOMER][NEUTRAL] Just give me a moment.
[CUSTOMER][NEUTRAL] Fax number is [PII].
[AGENT][NEUTRAL] So I have [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] What would be the what would be the turndown time to receive the fax?
[AGENT][NEUTRAL] I'm not sure that I, I'm not sure how long it would take for you to receive the fax, however, I know that I'm sending it over to you now.
[CUSTOMER][NEUTRAL] OK, uh, can you please uh spell out your name one more time for me?
[AGENT][NEUTRAL] [PII], and today's date is a reference, [PII] because unfortunately we don't provide reference numbers.
[CUSTOMER][NEUTRAL] Uh, what is the initial of your name? I, I, the, your voice is getting, uh,
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And use today's date as a reference of [PII] because we don't provide reference numbers.
[CUSTOMER][POSITIVE] OK, thank you, [PII]. Thank you for the information and thank you for assisting me. Have a nice day. Take care, bye for now.
[AGENT][POSITIVE] Thanks for calling APL. You have a great one as well, [PII]. Goodbye.