AccountId: 011433970860
ContactId: ecc341f4-eaeb-40bf-a459-65afffcc41b7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1373979 ms
Total Talk Time (AGENT): 389016 ms
Total Talk Time (CUSTOMER): 316774 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/ecc341f4-eaeb-40bf-a459-65afffcc41b7_20250320T14:43_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, myself Uja. I'm calling from Nicholas Children's Hospital provider office. I'm looking for claiming status.
[AGENT][POSITIVE] It would be my pleasure to assist you with.
[CUSTOMER][NEUTRAL] Your name is [PII]?
[AGENT][NEUTRAL] [PII] And do you mind spelling your name for documentation?
[CUSTOMER][POSITIVE] Yeah, definitely.
[CUSTOMER][NEUTRAL] [PII], your last initial name.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Thank you, [PII]. And [PII].
[AGENT][NEUTRAL] So what is a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] So [PII].
[AGENT][NEUTRAL] I apologize. Is it [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright, thank you and what is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] There is no policy number.
[AGENT][NEUTRAL] There's
[CUSTOMER][NEUTRAL] I have, sorry, just a moment.
[CUSTOMER][NEUTRAL] Yeah, policy number is 014.
[CUSTOMER][NEUTRAL] 82796
[AGENT][NEUTRAL] And the patient's name and date of birth, please, ma'am.
[CUSTOMER][NEUTRAL] Patient name is [PII].
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] And date of birth?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Date of birth is uh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And do you have a claim number or date of service?
[CUSTOMER][NEUTRAL] I have data service.
[AGENT][NEUTRAL] And that is
[CUSTOMER][NEUTRAL] Date of service [PII].
[AGENT][NEUTRAL] And the bill amount, please, ma'am.
[CUSTOMER][NEUTRAL] Uh, charges.
[CUSTOMER][NEUTRAL] Yeah, $3,267.96.
[AGENT][NEUTRAL] All right, thank you. And what is the name of the facility, please, [PII]?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Nicola Children's Hospital.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] I'm showing that we did receive that claim twice. The original claim we received on [PII] and processed on [PII].
[AGENT][NEUTRAL] And that claim number is 355.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 9489.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it is pending for the primary EOB.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sandi Obi.
[AGENT][NEUTRAL] We
[AGENT][NEUTRAL] That's right. We're needing the major medical EOB.
[AGENT][NEUTRAL] We received the claim again on [PII] and processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that claim number is 355.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] 9489.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it is still pending for the primary EOB.
[CUSTOMER][NEUTRAL] OK. So you'll be not received, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Give me a call reference number. I have uh
[CUSTOMER][NEUTRAL] More so please give me details. I have uh
[CUSTOMER][NEUTRAL] 7 p.m.
[AGENT][POSITIVE] Alright, I can help you with those. Give me just one second.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, the reference number is gonna be the same for the complete call and it's going to be my name and today's date.
[CUSTOMER][POSITIVE] OK, thanks.
[AGENT][POSITIVE] My pleasure. And I'm ready for the next policy number.
[CUSTOMER][NEUTRAL] Yeah, just a moment.
[CUSTOMER][NEUTRAL] Next policy number is uh
[CUSTOMER][NEUTRAL] 25
[CUSTOMER][NEUTRAL] 49426
[AGENT][NEUTRAL] And that patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient name is uh
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] All right, thank you and what is that data service?
[CUSTOMER][NEUTRAL] Date of service is [PII]. Charges $1,146.50.
[AGENT][NEUTRAL] Is that for Nicholas Children's Hospital as well?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] I'm checking on that claim.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that claim we received on 11-12-24.
[AGENT][NEUTRAL] And process on 1114 24.
[AGENT][NEUTRAL] Claim number is 353.
[AGENT][NEUTRAL] 0437.
[AGENT][NEUTRAL] And that claim is also pending for the primary EOB.
[CUSTOMER][NEUTRAL] Claim number 353-04737, right?
[AGENT][NEUTRAL] It's 353-043-7.
[CUSTOMER][NEUTRAL] Sorry, could you repeat that?
[AGENT][NEUTRAL] Sure. 353.
[AGENT][NEUTRAL] 0437.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] And I'm ready for the next.
[CUSTOMER][NEUTRAL] Can I move next plan?
[AGENT][POSITIVE] Yes, ma'am. I'm ready.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Policy number is 022730.
[CUSTOMER][NEUTRAL] 52
[AGENT][NEUTRAL] Name and date of birth?
[CUSTOMER][NEUTRAL] Name is [PII].
[CUSTOMER][NEUTRAL] [PII] and date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And that date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Build amount.
[CUSTOMER][NEUTRAL] $1,457.79.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Looks like we received that claim 3 times. The original claim.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We received on 9-17-24.
[AGENT][NEUTRAL] And process on 9-20-24.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Claim number?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Is 350.
[AGENT][NEUTRAL] 7658.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] And then we received the claim 2 other times, but they were denied as a duplicate.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Because the EOB was not attached.
[AGENT][NEUTRAL] Do you want that duplicate claim information as well?
[CUSTOMER][NEUTRAL] No, thank you.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] And I'm ready for the next one.
[CUSTOMER][NEUTRAL] That's
[CUSTOMER][NEUTRAL] Yes, next policy number is uh
[CUSTOMER][NEUTRAL] 022 03089
[AGENT][NEUTRAL] The name and date of birth?
[CUSTOMER][NEUTRAL] Name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you and that date of service?
[CUSTOMER][NEUTRAL] Date of services, uh.
[CUSTOMER][NEUTRAL] [PII], sorry, [PII].
[CUSTOMER][NEUTRAL] Charges $2,207.92.
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the name of that facility?
[CUSTOMER][NEUTRAL] Nicholas Children's Hospital.
[AGENT][NEUTRAL] And could it be under another hospital facility name?
[CUSTOMER][NEUTRAL] Just a moment, I will check.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Palmeto by outpatient.
[AGENT][NEUTRAL] What
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Under the Nicholas Children's Hospital.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That claim we received on
[AGENT][NEUTRAL] Let me get that received date for you. [PII].
[AGENT][NEUTRAL] Processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Claim number 35 I'm 3534732.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And that claim is pending for the primary EOB.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] Can you hear me?
[AGENT][NEUTRAL] I can hear you.
[CUSTOMER][NEUTRAL] Can I know next time?
[AGENT][POSITIVE] I'm ready.
[CUSTOMER][NEUTRAL] Next policy number is uh.
[CUSTOMER][NEUTRAL] It's 14.
[CUSTOMER][NEUTRAL] 19038.
[AGENT][NEUTRAL] Name and date of birth, please.
[CUSTOMER][NEUTRAL] Name is [PII].
[CUSTOMER][NEUTRAL] OK. And date of birth is [PII].
[AGENT][NEUTRAL] And date of service, please, ma'am.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] So this is uh.
[CUSTOMER][NEUTRAL] $1,191.83.
[AGENT][NEUTRAL] Alright, and just to verify that data service [PII]?
[CUSTOMER][NEUTRAL] No, [PII].
[AGENT][POSITIVE] [PII], thank you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And the bill amount again please, ma'am?
[CUSTOMER][NEUTRAL] The amount is $1,191.83.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Now that claim I do not have on file for the facility.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Ma'am, is active on data of service?
[AGENT][NEUTRAL] Yes, the effective date is [PII] and the policy is active.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the claim can be faxed to our claims department as well.
[AGENT][POSITIVE] And I'm ready for the next one whenever you are.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Next policy number is uh
[CUSTOMER][NEUTRAL] 02443497
[AGENT][NEUTRAL] And name and date of birth?
[CUSTOMER][NEUTRAL] Name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] All right, and the date of service, please.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Date of service is September.
[CUSTOMER][NEUTRAL] [PII] charges is $81.47.
[AGENT][NEUTRAL] And that facility name?
[CUSTOMER][NEUTRAL] Nicholas Children's Hospital.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] That claim we received, you get that received date.
[AGENT][NEUTRAL] On [PII].
[AGENT][NEUTRAL] 2024 and processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it is pending for the primary EOB.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Your number?
[AGENT][NEUTRAL] Oh, I'm so sorry. Claim number is 352.
[AGENT][NEUTRAL] 0547.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] And I'm ready for the next one.
[CUSTOMER][NEUTRAL] Only one plane.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Policy number is uh
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 01942505
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 01944505
[CUSTOMER][NEUTRAL] Sorry, once again, please.
[AGENT][NEUTRAL] 01944505
[CUSTOMER][NEUTRAL] No, no. 42, 42505.
[AGENT][NEUTRAL] OK. 019.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Repeat that.
[AGENT][NEUTRAL] Can you repeat the policy number?
[CUSTOMER][NEUTRAL] 0
[CUSTOMER][NEUTRAL] 1942505.
[AGENT][NEUTRAL] Mhm. Mhm.
[AGENT][NEUTRAL] All right. Let me get that. And name and date of birth?
[CUSTOMER][NEUTRAL] Man
[CUSTOMER][NEUTRAL] [PII] No No. Date of birth is [PII].
[AGENT][NEUTRAL] And it's for [PII]?
[CUSTOMER][NEUTRAL] Yeah, um.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the date of service?
[CUSTOMER][NEUTRAL] Date of service is [PII]. Chars is uh
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] And you said [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, bear with me just one moment. This policy termed in 21. I'm checking to see if [PII] has another policy.
[AGENT][NEUTRAL] Let me get the correct policy pulled up for that date of service.
[CUSTOMER][NEUTRAL] The policy is not active on that.
[AGENT][NEUTRAL] That policy was not, but I do see another policy, so I'm checking that policy to make sure [PII] is covered.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me give you the correct policy number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I guess I.
[CUSTOMER][NEUTRAL] Yes, please, go ahead.
[AGENT][NEUTRAL] OK, as of [PII], the active policy number is 225.
[AGENT][NEUTRAL] 0224.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 0224. 02250224, right?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That's correct. And I do have a claim on file for data service 10824. What was the bill amount?
[CUSTOMER][NEUTRAL] The amount is uh
[CUSTOMER][NEUTRAL] $3,07.43.
[AGENT][NEUTRAL] All right, thank you. And that's Nicholas Children's Hospital?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Is that the facility name?
[CUSTOMER][NEUTRAL] Can you collect children on Hospital?
[AGENT][POSITIVE] Yes, ma'am. OK, thank you. All right, we received that claim twice.
[AGENT][NEUTRAL] The original claim we received on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] Processed on [PII] and pending for the primary EOB.
[AGENT][NEUTRAL] We received the claim.
[CUSTOMER][NEUTRAL] Give me a claim number.
[AGENT][NEUTRAL] Yeah, the claim number is 3,532,510. We did receive the claim again in [PII] and process and processed as a duplicate, denied as duplicate.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Anything else I can help you with?
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] Oh, it's been such a pleasure to help you with that claim status. Well, thank you for calling APL and I hope you have a wonderful day.
[CUSTOMER][NEGATIVE] No thank you.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] OK, thank you. Bye-bye.
[AGENT][NEUTRAL] Bye-bye.