AccountId: 011433970860
ContactId: 71ca2cf2-9fd9-468a-8a48-68ac3d11fd79
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 443489 ms
Total Talk Time (AGENT): 99475 ms
Total Talk Time (CUSTOMER): 71069 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=-1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/71ca2cf2-9fd9-468a-8a48-68ac3d11fd79_20250310T20:54_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. Last [PII]. Can you please help me with the claim status?
[AGENT][NEUTRAL] Yes, I can, [PII]. um, can you please uh give me your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And you're needing claim status on what patient, [PII]?
[CUSTOMER][NEUTRAL] I have the member ID. Uh, it is 241.
[CUSTOMER][NEUTRAL] 9368.
[AGENT][NEUTRAL] OK, and what's the member's name and date of birth?
[CUSTOMER][NEUTRAL] Member's name, [PII].
[CUSTOMER][NEUTRAL] [PII]. Date of birth [PII].
[AGENT][NEUTRAL] OK, let me look up that policy real quick.
[AGENT][NEUTRAL] OK, and then what is the data service in charge amount?
[CUSTOMER][NEUTRAL] Date of service, [PII]. And the total charge amount of $9880.08.
[AGENT][NEUTRAL] OK, and what is the charge after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Just allow me a second. It is only for
[CUSTOMER][NEUTRAL] $480.
[AGENT][NEUTRAL] Thank you and then what's the name of the facility you're calling for [PII]?
[CUSTOMER][NEUTRAL] Nicholas Children's Hospital.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I look up this claim for you and I'll be right back.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding for me, [PII]. So looking on data service of [PII] and the amount of $9880.08 before primary and $480 after primary for [PII], I do not find a claim on file.
[CUSTOMER][NEUTRAL] OK. Could you check, uh check with the different, uh, total charge amount if possible?
[AGENT][NEUTRAL] OK, what is that amount?
[CUSTOMER][NEUTRAL] It is $10,938.66.
[AGENT][NEUTRAL] OK, and the charge after primary.
[CUSTOMER][NEUTRAL] Same, the $4000 480 dollars.
[AGENT][NEUTRAL] 480. OK, let me look real quick, sir.
[AGENT][NEUTRAL] I'm gonna put you on a brief hold.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding for me, [PII]. So with that amount we I did find the claim.
[AGENT][NEUTRAL] The claim number is 3465518.
[AGENT][NEUTRAL] And the claim was denied because we need the explanation of benefits from the primary insurance carrier.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you, thank you for your help.
[AGENT][POSITIVE] You're very welcome.
[AGENT][NEUTRAL] Is there anything else I can help you with today, [PII]?
[CUSTOMER][NEUTRAL] No. Thank you.
[AGENT][POSITIVE] Alright well you have a wonderful day and thank you for calling APL bye bye.