AccountId: 011433970860
ContactId: 87398c40-3e80-4b88-9a4d-f918459ac77a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 814700 ms
Total Talk Time (AGENT): 149279 ms
Total Talk Time (CUSTOMER): 193915 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/87398c40-3e80-4b88-9a4d-f918459ac77a_20250326T19:47_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, this is [PII] from provider office and I'm looking for claims status.
[AGENT][NEUTRAL] OK [PII], I can help you with client claim status. Can I please get your callback number, sir?
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Who.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so the callback number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, sir. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So the business name is uh Neo Anderdo and the date of birth is on [PII].
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] And the policy number, please?
[CUSTOMER][NEUTRAL] OK. It's uh
[CUSTOMER][NEUTRAL] Is it 693
[CUSTOMER][NEUTRAL] 281-6064.
[AGENT][NEUTRAL] OK, that is not one of our policy numbers. Do you have another number that you see?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] One moment, one moment, let me check.
[AGENT][POSITIVE] Yes, go ahead and take your time.
[CUSTOMER][NEUTRAL] OK, please take uh
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello, I'm here.
[CUSTOMER][NEUTRAL] OK. So
[CUSTOMER][NEUTRAL] Yeah. Uh, check the policy number. It's uh 1 it's 1984141.
[AGENT][NEUTRAL] OK, let me check that real quick.
[AGENT][NEUTRAL] OK, and you said the member's name was [PII] and the date of birth is [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. I do not have a [PII] with that date of birth.
[AGENT][NEUTRAL] I have another member with that date of birth.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yes, yes. Yes, yes. It's uh [PII] and [PII]. One moment, let me check in the previous, uh, one moment.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Please be on hold, let me check.
[AGENT][NEUTRAL] Yes, go ahead.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Yes, sir. I'm here.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Yes, I'm here.
[CUSTOMER][NEUTRAL] Yeah, uh.
[CUSTOMER][NEUTRAL] OK, um
[CUSTOMER][NEUTRAL] OK, so the uh policy number is 1984141.
[CUSTOMER][NEUTRAL] And uh mm
[CUSTOMER][NEUTRAL] The name is the subscriber is [PII] and Jardu.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] And what is the patient's name?
[CUSTOMER][NEUTRAL] His name is [PII].
[AGENT][NEUTRAL] Patient's name is [PII].
[AGENT][NEUTRAL] Or [PII]. Did you say [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I'm not showing that name, but I do see the date of birth for another member of that policy.
[AGENT][NEUTRAL] What is the date of service of the claim?
[CUSTOMER][NEUTRAL] One moment data service.
[CUSTOMER][NEUTRAL] It's uh uh [PII].
[AGENT][NEUTRAL] OK, and what is the charge amount?
[CUSTOMER][NEUTRAL] It's a 696 dollars.22 cents.
[AGENT][NEUTRAL] OK, and then what is the charges after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][NEUTRAL] It's uh $325.
[AGENT][NEUTRAL] OK. And [PII], what is the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] It's a Nicholas Children Hospital.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I try to find that claim for you and I will be right back.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, OK. Please.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hi [PII], this is [PII] back with you again.
[AGENT][NEUTRAL] Could the claim be under a different provider name?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me check.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Pro uh uh Rosado Gonzalez.
[CUSTOMER][NEUTRAL] And Karen M.
[AGENT][NEUTRAL] MKM.
[CUSTOMER][NEUTRAL] Are
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] What does that stand for?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Provider is Karen M and uh Rosado Gonzalez.
[AGENT][NEGATIVE] No, that's not the right provider. I have a claim, but it's not under the provider name that you've given me.
[CUSTOMER][NEUTRAL] OK, no, let me check one moment.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Is a provider facility name.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] OK. So it's a
[CUSTOMER][NEUTRAL] Rose I do.
[CUSTOMER][NEUTRAL] Goalla like R O S A D O.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Can you say your full name?
[AGENT][NEUTRAL] I'm sorry, what did you just say, sir?
[CUSTOMER][NEUTRAL] Can you spell full name, provide the full name?
[AGENT][NEUTRAL] No, I don't see Fulham.
[CUSTOMER][NEUTRAL] No, no, can I spell name of the provider?
[AGENT][NEUTRAL] I can't give you the provider name.
[CUSTOMER][NEUTRAL] Can I spell?
[AGENT][NEUTRAL] Yes, you can spell.
[CUSTOMER][NEUTRAL] OK. So, R as in Romeo, O as in Oscar, S as in Sam, as in Alpha, D as in Delta, O as in Oscar, and the last name is G as in girl, O as in Oscar, N as in Nancy, Z as in Zebra, A as in Alpha, L as in Lima, E as in Echo, Z as in zebra.
[AGENT][NEUTRAL] No, that's not the provider.
[AGENT][NEUTRAL] Um, so we do not have a claim on file with the provider name that you have given us.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] One moment, one moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Yeah, hello.
[CUSTOMER][NEUTRAL] Hello. Yes, I have the same provider.
[AGENT][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Yes, I have the same provider. Um, do you need anything else for this game?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, no, sir. I, I don't have the claim on file for the provider name given.
[CUSTOMER][POSITIVE] Good
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] For that amount.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] You don't have a claim.
[AGENT][NEUTRAL] I don't have claim on file for that provider name given for the amount given.
[CUSTOMER][NEUTRAL] One moment.
[AGENT][POSITIVE] Yes, sir. Take your time.
[CUSTOMER][NEUTRAL] OK, what's your name?
[AGENT][NEUTRAL] My name is [PII]
[CUSTOMER][NEUTRAL] To
[CUSTOMER][NEUTRAL] Oy.
[CUSTOMER][NEUTRAL] What's the call reference number?
[AGENT][NEUTRAL] It would be my name and today's date.
[CUSTOMER][POSITIVE] OK, OK, sorry. Thank you, that's all for the day.
[AGENT][POSITIVE] You're welcome, [PII]. I hope you have a good day and thank you for calling APL.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] Bye-bye, sir.
[CUSTOMER][NEUTRAL] Really