AccountId: 011433970860
ContactId: a0ed2073-0f93-4353-aec1-51f2061e7c18
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 494820 ms
Total Talk Time (AGENT): 182438 ms
Total Talk Time (CUSTOMER): 134255 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/a0ed2073-0f93-4353-aec1-51f2061e7c18_20250114T19:59_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. I'm calling from Neglect Children's Hospital provider office. I'm looking for claiming status.
[AGENT][NEUTRAL] OK, can you spell your name for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, it's pronounced [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and what's the policy number, [PII]?
[CUSTOMER][NEUTRAL] Give me your name, please.
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Transition, please.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Could you repeat that your name?
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And your policy number or the patient's policy number?
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Yes, policy number is uh
[CUSTOMER][NEUTRAL] 022
[CUSTOMER][NEUTRAL] 03 089
[CUSTOMER][NEUTRAL] ML 8.
[AGENT][NEUTRAL] And I get phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Phone number, right?
[AGENT][NEUTRAL] A phone number in case we are disconnected?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] What's the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Patient name is [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII]. Sorry, [PII].
[AGENT][NEUTRAL] Thank you. Can you provide the date?
[AGENT][POSITIVE] Thank you. Can you provide?
[CUSTOMER][NEUTRAL] Yeah,
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Thank you. Can you provide the date of service and total charge?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh just a moment.
[CUSTOMER][NEUTRAL] Date of service is [PII]. range is [PII].
[CUSTOMER][NEUTRAL] Charges $760.37.
[AGENT][NEUTRAL] And what is it
[AGENT][NEUTRAL] $760.37.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, what type of service is this for?
[CUSTOMER][NEUTRAL] Claiming status.
[AGENT][NEUTRAL] What types
[CUSTOMER][NEUTRAL] Medical.
[AGENT][NEUTRAL] I get that. Is it physical therapy? Is it a surgery? What type of service?
[CUSTOMER][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, therapy.
[AGENT][NEUTRAL] Physical therapy?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Please check claim why denied. What is the reason.
[AGENT][NEUTRAL] Yeah, I'm checking. Could you hold for a second for me, Pooja, until I search for that claim?
[CUSTOMER][NEUTRAL] Yes, sure.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the name of the hospital?
[CUSTOMER][NEUTRAL] Nicholas Children's Hospital.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so the information that we received, it's an uh hospital bill. I do show that the total charges for $760.37 but I'm only showing one date of service on the claim and that's [PII], and it is for physical therapy. Is this the claim that you're asking for status?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. So we are requesting a copy of the major medical explanation of benefits.
[AGENT][NEGATIVE] Uh, it was not received with this claim.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I do show that the claim was received [PII].
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Processed
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And let me know when you're ready for the claim number, Puja.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] That number is 352.
[AGENT][NEUTRAL] 9387.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you can also check your status.
[CUSTOMER][NEUTRAL] 9387.
[AGENT][NEUTRAL] 9387. That is correct.
[CUSTOMER][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] And you can also check claim status on the online service center at [PII]. And did you have any other questions I can help out with today?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] No, thank you. And give me address for your information address.
[AGENT][NEUTRAL] Mhm. It's [PII]. Well, it's [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The state is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] I'm sorry, it's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you. Give me call reference number and I have one more claim.
[AGENT][POSITIVE] You're welcome. And
[AGENT][NEUTRAL] You'll use my name in today's status reference for today's call. Is it for a different patient?
[CUSTOMER][NEUTRAL] Yes, patient is different.
[AGENT][NEUTRAL] And what is the policy number, ma'am?
[CUSTOMER][NEUTRAL] Policy number is 01482796.
[AGENT][NEUTRAL] The date of the patient.
[CUSTOMER][NEUTRAL] ML 7.
[AGENT][NEUTRAL] The patient's name and date of date of birth, please?
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Yeah, but your name is [PII].
[CUSTOMER][NEUTRAL] [PII] and date of birth is [PII].
[AGENT][POSITIVE] Thank you. And date of service and total charge?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Charge is $17.23.
[AGENT][NEUTRAL] OK. We're needing a copy of the major medical explanation of benefits.
[AGENT][NEUTRAL] Um, I'm showing that this claim was received [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Processed [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 24
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim number?
[CUSTOMER][NEUTRAL] Claim number? Mhm.
[AGENT][NEUTRAL] Mhm. 352.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] 0150.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] All righty. Anything else?
[CUSTOMER][POSITIVE] No, thank you so much.
[AGENT][POSITIVE] All righty. Thank you for calling