AccountId: 011433970860
ContactId: 6b98f5c0-d185-4908-b000-686bad27af73
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 223020 ms
Total Talk Time (AGENT): 88246 ms
Total Talk Time (CUSTOMER): 82303 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/6b98f5c0-d185-4908-b000-686bad27af73_20250417T17:21_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, yes, hi, good um, good afternoon. My name is [PII]. I'm calling from Nicholas Children's Hospital. I'm calling to get the status of a submit a claim.
[AGENT][NEUTRAL] Yeah, I could check on a claim for you. [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure. It's [PII].
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Uh yes, that would be 02123355 ML 7.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for the member, please?
[CUSTOMER][NEUTRAL] This is for [PII] Date of birth is [PII].
[AGENT][NEUTRAL] Perfect. OK, thank you for verifying that and then what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Uh, this was for [PII].
[AGENT][NEUTRAL] OK, do you have that bill amount?
[CUSTOMER][NEUTRAL] Uh yes, ma'am. It's $3,755.05.
[AGENT][POSITIVE] Got it, thank you one moment please.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so we did receive this claim, [PII], we were unable to pay a benefit as their outpatient benefit for the calendar year had been met.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, so that would be patients responsibility at this point.
[AGENT][NEUTRAL] Uh, we don't say what is patient responsibility that would be up to the provider.
[CUSTOMER][NEUTRAL] OK, can I get up and already for the, for the, for this year it's already met for [PII]?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, that looks like that's the date that it was as well. We have received several claims for [PII].
[CUSTOMER][POSITIVE] OK, wow.
[CUSTOMER][NEUTRAL] Understood. Can I get a reference number for this? Oh, I'm sorry, can I get the claim number?
[AGENT][NEUTRAL] Absolutely, yes, that's uh 356-891-1.
[AGENT][NEUTRAL] And if you'd like [PII], I can send you the the EOB if you need that for your records.
[CUSTOMER][NEUTRAL] Co
[CUSTOMER][POSITIVE] Uh, yes, I can give you my fax number. It will come directly to my email.
[AGENT][POSITIVE] Perfect. OK, what was that fax number for you?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I'm going to read that back to make sure I heard that correctly. That was [PII]?
[CUSTOMER][POSITIVE] Yes ma'am, thank you.
[AGENT][POSITIVE] OK, yes, I'll go ahead and get that sent now. Um, you probably get it within about 10 minutes or so. Was there anything else I could help you with?
[CUSTOMER][POSITIVE] That's wonderful.
[CUSTOMER][NEUTRAL] Just a call reference number please.
[AGENT][NEUTRAL] Sure, that would just be my first name, last initial, and today's date, and so my name is spelled [PII], last initial is [PII]
[CUSTOMER][POSITIVE] Beautiful. Thank you so much for your help and you have a wonderful rest of your day. Thank you. Bye.
[AGENT][NEUTRAL] Of course.
[AGENT][POSITIVE] Yeah, thanks for APL. You too. Bye bye.
[CUSTOMER][NEUTRAL] Mhm bye bye.