AccountId: 011433970860
ContactId: 6372c5d8-0330-42f9-a7e0-1568a317a00d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 496160 ms
Total Talk Time (AGENT): 176208 ms
Total Talk Time (CUSTOMER): 150820 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/6372c5d8-0330-42f9-a7e0-1568a317a00d_20250121T16:17_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I help you?
[AGENT][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Uh hello, [PII]. How are you?
[AGENT][NEUTRAL] Fine, how are you?
[CUSTOMER][NEUTRAL] Yeah, I'm fine. Thank you for thank you for asking me. Uh, actually, I'm calling on behalf of our office and looking for a claim status.
[AGENT][NEUTRAL] OK, I can help you with claim status, and may I ask who I'm speaking with?
[CUSTOMER][NEUTRAL] Uh, Mr. [PII].
[AGENT][NEUTRAL] And [PII], in case this call is disconnected, may I have your callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number, please?
[AGENT][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello?
[AGENT][NEUTRAL] Are you still there?
[CUSTOMER][NEUTRAL] Yes, [PII]. Yes, I am here. I'm, I can hear you.
[AGENT][NEUTRAL] May I have the patient's policy number, please?
[CUSTOMER][NEUTRAL] And the patient pulse age.
[CUSTOMER][NEUTRAL] Let me check, uh
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 0202
[CUSTOMER][NEUTRAL] 021777 [PII].
[AGENT][NEUTRAL] And that was 020202177 [PII]?
[CUSTOMER][NEUTRAL] No, no. Uh, can I speak up again? Uh, member ID 02021777 ML8.
[AGENT][NEUTRAL] Thank you. And may I have the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, patient name is [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And may I have the date of service and the bill amount of the claim?
[CUSTOMER][NEUTRAL] So, date of service is [PII] and the total charge amount is $760.37.
[AGENT][NEUTRAL] Thank you. So it's for data service of [PII] for $760.37.
[CUSTOMER][POSITIVE] Yes, yes, yes.
[CUSTOMER][POSITIVE] Yes, it will be correct.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the name of the provider?
[CUSTOMER][NEUTRAL] Uh, Nicholas Children's Hospital.
[AGENT][NEUTRAL] OK, I show you have a claim for a data service of [PII] for that same build about, but not a claim for data service of [PII] data service.
[CUSTOMER][NEUTRAL] Yes, uh, [PII].
[CUSTOMER][POSITIVE] That is correct.
[AGENT][NEUTRAL] OK, I only show that we have a claim for [PII], no claim for [PII].
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Yes, yes.
[CUSTOMER][NEUTRAL] OK, yeah, yes, [PII].
[AGENT][NEUTRAL] OK, so I do show we received the claim for [PII] that was received on [PII]. It was processed on [PII]. We requested the primary insurance carrier explanation of benefits.
[AGENT][NEGATIVE] That was not received.
[CUSTOMER][NEUTRAL] Uh food.
[CUSTOMER][NEUTRAL] OK. The 4 primary UV correct?
[AGENT][NEUTRAL] Correct. Would you like the claim number?
[CUSTOMER][NEUTRAL] Uh yes.
[AGENT][NEUTRAL] The claim number is 351-7264.
[CUSTOMER][NEUTRAL] And the claim number is?
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, OK.
[CUSTOMER][NEUTRAL] OK. May I have the reference number for this claim?
[AGENT][NEUTRAL] It'd be just my name and that's [PII] spelled [PII] Is there anything else I can assist you with today, [PII]?
[CUSTOMER][POSITIVE] Yes, actually, I have one more claim. So let's move for another claim.
[AGENT][NEUTRAL] Is it for the same patient?
[CUSTOMER][NEUTRAL] Uh, different patients, but the same facility.
[AGENT][NEUTRAL] OK, give me one moment, please. Give me one moment, please.
[CUSTOMER][NEUTRAL] And the next member ID is?
[CUSTOMER][POSITIVE] Take your time. Take your time, take your time.
[AGENT][NEUTRAL] OK, what is the data service?
[AGENT][NEUTRAL] I mean, I'm sorry, what is the policy number?
[CUSTOMER][NEUTRAL] Uh, that is.
[CUSTOMER][NEUTRAL] OK. Policy number is 01942482ML8.
[AGENT][NEUTRAL] Thank you, and that was 01942482 MO 8?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And may I have the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Pa, patient name is [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And what is the date of service and the build amount?
[CUSTOMER][NEUTRAL] Date of service is [PII]. And the total charge is $610.68.
[AGENT][NEUTRAL] Thank you. So that's for data service [PII] for $610.68.
[CUSTOMER][POSITIVE] Yeah, yes, yes, yes. Correct.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEGATIVE] They don't.
[AGENT][NEUTRAL] OK, I do show we received that claim. Looks like we received that claim twice. Looks like we initially received that claim on August on [PII]. It was processed on [PII]. We requested the primary care explanation of benefits and then we received the.
[CUSTOMER][NEUTRAL] Wait, wait, wait. [PII]. This is a process date. Correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] On the night for primary UV.
[AGENT][NEUTRAL] Correct. It looks like we received that claim again and we still did not receive the primary care explanation of benefits that was received on [PII] and processed on [PII] as a duplicate cause we still did not receive the primary care explanation of benefits. Would you like the claim number?
[CUSTOMER][NEUTRAL] Correct?
[CUSTOMER][NEUTRAL] Uh, may I know the claim number?
[CUSTOMER][NEUTRAL] Yes. Original claim number.
[AGENT][NEUTRAL] The claim number is 354.
[AGENT][NEUTRAL] The original claim? Sure. That claim number is 3507724.
[CUSTOMER][NEUTRAL] Original claim number.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK. Thank you, [PII]. Have a nice day. Bye-bye.
[AGENT][POSITIVE] You're welcome. You too, thanks for calling APL bye.
[CUSTOMER][NEUTRAL] Oh