AccountId: 011433970860
ContactId: 93345ab3-92b8-427b-b4a3-00a62436ad4b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 228449 ms
Total Talk Time (AGENT): 97934 ms
Total Talk Time (CUSTOMER): 71626 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/93345ab3-92b8-427b-b4a3-00a62436ad4b_20250123T14:01_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling on behalf of Nicholas Children's Hospital to check on a claim status.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status. And [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sure, um, my number is [PII] sorry, and the policy number is 01527418.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII] [PII].
[CUSTOMER][NEUTRAL] Last and then there's a [PII] then [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that. And all the information provided is a verification of benefits, not a guarantee of payment. Um, and so may I have the date of service for the claim you'd like me to check on for [PII]?
[CUSTOMER][NEUTRAL] Uh, sure, it's 10/7 of 24.
[AGENT][NEUTRAL] And may I have the total bill amount?
[CUSTOMER][NEUTRAL] Uh, $1490.09.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] So I'm showing we received the claim on [PII].
[AGENT][NEUTRAL] Actually, hold on one moment. What's your tax ID?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, um, I only ask because I know you said [PII], but it came up with Kendall outpatient, so I wasn't sure if it was the same thing. So thank you for verifying.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, so, we received it on [PII]. The claim number is 353.
[AGENT][NEUTRAL] 70
[AGENT][NEUTRAL] 08
[AGENT][NEUTRAL] And on [PII].
[AGENT][NEUTRAL] The claim was denied.
[AGENT][NEUTRAL] Requesting the explanation of benefits from their primary insurance.
[CUSTOMER][NEUTRAL] OK, um, is there a fax number we can send that to or?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Let me know when you're ready.
[CUSTOMER][POSITIVE] OK, I'm ready.
[AGENT][NEUTRAL] OK, so the fax number is [PII].
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK, does anything else need to come with that or just the EOB?
[AGENT][NEUTRAL] Oh no, ma'am, just the EOB and once we receive it, we'll go ahead and continue processing.
[CUSTOMER][NEUTRAL] OK, and do we need to put an attention to?
[AGENT][NEUTRAL] Um, that'll be attention APL claims department.
[AGENT][NEUTRAL] And if you wanted to like reference the policy number or the claim number, you could.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, I will, I will get that sent over to you all here in just a few minutes. Um, could you, do you give a reference number for your calls?
[AGENT][NEUTRAL] Um, so there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] OK, alright, and I thank you so much for your help today, [PII].
[AGENT][POSITIVE] You're very welcome, [PII]. Well, thanks for calling APL and I hope you have a great day.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][POSITIVE] Thank you. Bye bye.