AccountId: 011433970860
ContactId: c1b0a9a4-727b-4b62-99a8-b0073c00074a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 279239 ms
Total Talk Time (AGENT): 116786 ms
Total Talk Time (CUSTOMER): 83548 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/13/c1b0a9a4-727b-4b62-99a8-b0073c00074a_20250113T20:20_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yes, hi, good afternoon, [PII]. My name is [PII]. I'm calling from Nicola Children's Hospital following up on a claim status.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, [PII], you're checking on a claim status for a member, is that correct?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][POSITIVE] Yes, ma'am, I can help you with that. And [PII], what is a good callback number for you?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you and the member's policy number, please.
[CUSTOMER][NEUTRAL] 02372885 M as in Mary, L as in Larry 8.
[AGENT][NEUTRAL] OK, thank you. One moment please.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And any information [PII] that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name please and their date of birth?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] This is for [PII], [PII].
[AGENT][NEUTRAL] Thank you and the date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] [PII] for $3180 and.
[AGENT][NEUTRAL] Oh, I'm sorry. [PII], are you still there? Your voice cut out.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, what was the total bill amount again?
[CUSTOMER][NEUTRAL] OK, the total charges is.
[CUSTOMER][NEUTRAL] $3180.64.
[AGENT][NEUTRAL] 64 cents. OK, thank you, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. So this claim has actually the most recently received claim was denied as a duplicate. Would you like the original claim status?
[CUSTOMER][NEUTRAL] Well, I believe the original claim was requesting that primary EOB.
[AGENT][NEUTRAL] Yes, ma'am, but we've received the claim again.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] That's weird. OK, um, now on the original, which is 346-529-9, we faxed the copy of the primary EOB on [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, so what the 2nd, let me see the date of the 2nd information receipt. So we, no, we never received that apparently.
[CUSTOMER][NEUTRAL] OK, I have confirmation and everything that we faxed it.
[CUSTOMER][NEUTRAL] Where can I mail this to?
[AGENT][NEUTRAL] It may be mailed to [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] And that is [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, and can I get a reference number for this call, please?
[AGENT][POSITIVE] Yes ma'am, you will actually use my name along with today's date.
[CUSTOMER][POSITIVE] OK, perfect then.
[AGENT][NEUTRAL] And also, oh, and [PII], I don't know if you were given our website before where you can actually access the explanation of benefits for APL for the review that we've done. OK, good. OK, well, is there anything else that I can help you with today?
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Yes ma'am, I did I.
[CUSTOMER][POSITIVE] OK, alrighty.
[CUSTOMER][POSITIVE] No, that was it. Thank you very very much for your help and you have a wonderful rest of your day.
[AGENT][POSITIVE] Uh, oh, thank you so much and I hope you have a nice afternoon as well, and thank you again for calling APL.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][POSITIVE] You're welcome. Bye-bye.