AccountId: 011433970860
ContactId: d6a3a8f4-0a48-4841-8178-6c271543f43e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 171639 ms
Total Talk Time (AGENT): 80751 ms
Total Talk Time (CUSTOMER): 54908 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/2025/05/21/d6a3a8f4-0a48-4841-8178-6c271543f43e_20250521T14:11_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Uh, yes, hi, my name is [PII]. I'm calling from Nicola Children's Hospital following up on the status of a claim.
[AGENT][NEUTRAL] OK, I can verify claim status for you, Ms. [PII], and what is that policy number, please?
[CUSTOMER][NEUTRAL] 1346369, M as in Mary, L as in Larry, 8.
[AGENT][NEUTRAL] Thank you. One moment. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you and.
[AGENT][NEUTRAL] And verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] This is for [PII], [PII].
[AGENT][NEUTRAL] OK, and what was the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] [PII] for $16,793.93.
[AGENT][NEUTRAL] Thank you, ma'am. And do you have the balance after Primary is processed the claim?
[CUSTOMER][NEUTRAL] Yes, that would be $4,762.60.
[AGENT][POSITIVE] Thank you ma'am, give me one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Yes, and while I'm looking up claim information just to let you know we do have an online service center where providers can check claim status as well as print out the EOB.
[AGENT][NEUTRAL] That site is at [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you're calling from?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Nicholas Children's Hospital.
[AGENT][POSITIVE] OK, thank you, ma'am.
[AGENT][NEUTRAL] OK, I show the claim process as benefits are payable only if the major medical insurance provider provides benefits.
[AGENT][NEUTRAL] Meaning, um, if primary applies any amounts towards deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] So you need the primary EOB.
[AGENT][NEUTRAL] Yes, ma'am. If the primary EOB shows that amount was applied towards deductible, co-pay or co-insurance, uh, we would need that so we can go back and reprocess the secondary.
[CUSTOMER][NEUTRAL] OK, what is the claim number?
[AGENT][NEUTRAL] 36027667
[CUSTOMER][NEUTRAL] OK, perfect. Can I get a reference number for this call?
[AGENT][NEUTRAL] Uh, if you like, you may use my name in today's date.
[CUSTOMER][POSITIVE] Perfect. Thank you very much. You have a wonderful rest of your day.
[AGENT][POSITIVE] Uh, you too, Ms. [PII], and thanks for calling APL.
[CUSTOMER][NEUTRAL] Mhm bye bye.
[AGENT][NEUTRAL] Bye.