AccountId: 011433970860
ContactId: b11d7332-f564-4559-85d3-6453feaf658b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 330609 ms
Total Talk Time (AGENT): 104027 ms
Total Talk Time (CUSTOMER): 82521 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/b11d7332-f564-4559-85d3-6453feaf658b_20250224T15:18_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. I have two claims to check the status of if I could.
[AGENT][POSITIVE] OK, I'll be more than happy to help you with the claim status, and are they for the same member or two different members?
[CUSTOMER][NEUTRAL] Uh, 2 different members, please.
[AGENT][NEUTRAL] OK. And may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the first member's policy number?
[CUSTOMER][NEUTRAL] Yes, it's 254-498-6.
[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] Yes, it's [PII]. 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. And may I have the date of service and the total bill for the claim?
[CUSTOMER][NEUTRAL] Yes, it's 1024 of 24 and it's $587.01.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] 32, OK. So I'm strongly received the claim on [PII].
[AGENT][NEUTRAL] The claim number is 3553832.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And wait, I'm sorry, what was the name of your provider's office?
[CUSTOMER][NEUTRAL] Nichols Children's Hospital.
[AGENT][NEUTRAL] Wait a minute. What's your tax ID?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, it came over Palmetto Bay outpatient and I, I wasn't sure if that was the same thing, um, but it's the same tax ID. So, um,
[AGENT][NEGATIVE] It was denied requesting the explanation of benefits from primary insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I do have the fax number and stuff so I'll fax that over and it's just attention claims department, correct?
[AGENT][POSITIVE] Yes, that's correct.
[AGENT][POSITIVE] OK, and I'm ready for the next member's policy number when you're ready.
[CUSTOMER][NEUTRAL] OK. Uh, the next one is 02430725 M for Mike, L for Lima, number 8.
[AGENT][NEUTRAL] OK, can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that. And the date of service and total bills?
[CUSTOMER][NEUTRAL] Uh, 7124 through 731 24 total bill is $4,671.52.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And 252.
[AGENT][NEUTRAL] OK, this is it.
[AGENT][NEUTRAL] So shall I receive the claim on [PII]?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The claim number is 3,563,120.
[AGENT][NEUTRAL] And on [PII], the claim was denied requesting the explanation of benefits from primary.
[CUSTOMER][NEUTRAL] Bye
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And if I could just have a reference number for the call, I think that's all I need today.
[AGENT][NEUTRAL] All right, 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][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, and I thank you for your help today.
[AGENT][POSITIVE] You're very welcome and thanks for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] You too. Thank you. Bye bye.
[AGENT][POSITIVE] You're welcome bye bye.