AccountId: 011433970860
ContactId: 8204e238-2182-47d2-aac4-38e947ce55e2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 433700 ms
Total Talk Time (AGENT): 101531 ms
Total Talk Time (CUSTOMER): 122562 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/18/8204e238-2182-47d2-aac4-38e947ce55e2_20250318T16:41_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling on behalf of Nicholas Children's Hospital to check a couple claim statuses.
[AGENT][NEUTRAL] Sure, [PII], I can assist you with that. Can I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] And the first policy number is 01935547M for [PII] for Larry number [PII].
[AGENT][NEUTRAL] Thank you, could you verify that patient's name and date of birth that you're checking claim status for?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] And what is the date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Do you have a charge amount?
[CUSTOMER][NEUTRAL] Uh, $2,283.52.
[AGENT][NEUTRAL] The claim was received [PII]. It was processed [PII]. We're requesting the EOB to be sent in from the primary insurance company.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I will fax that over.
[CUSTOMER][NEUTRAL] After our call.
[AGENT][NEUTRAL] Would you like that claim number, [PII]?
[CUSTOMER][NEUTRAL] Uh yes, please.
[AGENT][NEUTRAL] It's 356-2079.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you for that.
[AGENT][NEUTRAL] You're welcome. What is the next policy number?
[CUSTOMER][NEUTRAL] And that's it on that one.
[CUSTOMER][NEUTRAL] 02344570 M for Mike, L for Larry, number 7.
[AGENT][NEUTRAL] And what is the member's name and date of birth that you're calling checking status of a claim for?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] And what is the date of service that you're inquiring about today?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Let me give you the correct policy number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's 254-498-6.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] What is the bill amount?
[CUSTOMER][NEUTRAL] Um, $4,981.12.
[CUSTOMER][NEUTRAL] Uh
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Looks like we need the EOB as well for this state of service.
[AGENT][NEUTRAL] Claim was received [PII]. It was processed [PII]. This is a gap insurance. Are you, are you guys aware of that?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I'm unsure about that. Let me double.
[CUSTOMER][NEUTRAL] Does it state that on the um on the card?
[CUSTOMER][NEUTRAL] I'll make a note of that.
[AGENT][NEUTRAL] The claim number is 3562556.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm. And I just have one.
[AGENT][NEUTRAL] What's the next policy number?
[CUSTOMER][NEUTRAL] Yeah. Um, the next one is.
[CUSTOMER][NEUTRAL] 01480322
[AGENT][NEUTRAL] And what is the member's name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] And what is the date of service that you're inquiring claim status for today?
[CUSTOMER][NEUTRAL] [PII] through [PII].
[AGENT][NEUTRAL] That would be considered as a hospital stay.
[CUSTOMER][NEUTRAL] Uh yes.
[CUSTOMER][NEUTRAL] I believe so.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] What is your bill amount?
[CUSTOMER][NEUTRAL] Uh, $5,292.90.
[AGENT][NEUTRAL] I'm not showing the claim on file for [PII].
[AGENT][NEUTRAL] And you said through what date of service?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] I'm not showing the claim on file.
[CUSTOMER][NEUTRAL] I will check all the information that we have and um get it resubmitted over you and that's all that I had today just I just need a reference number for our call.
[AGENT][NEUTRAL] You don't provide those, [PII], however, you can use my name and today's date as a reference is [PII].
[CUSTOMER][POSITIVE] All right, and I thank you for your help today.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL and you have a great day. Goodbye.
[CUSTOMER][NEUTRAL] You too.