AccountId: 011433970860
ContactId: f0fef78b-344a-495e-97b5-535f5f52c9c9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 402140 ms
Total Talk Time (AGENT): 94751 ms
Total Talk Time (CUSTOMER): 102430 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/f0fef78b-344a-495e-97b5-535f5f52c9c9_20250204T16:35_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling on behalf of Nicholas Children's Hospital, and I have a few claims to get a status of, please.
[AGENT][NEUTRAL] OK, [PII], um, just so you know, you can also check claim status on the online service center at [PII].
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] Um, the first policy number is.
[CUSTOMER][NEUTRAL] Um 01836290 M for [PII] L7.
[AGENT][NEUTRAL] And how many do you have?
[CUSTOMER][NEUTRAL] Um, I have 3 if I could. If not, that's OK.
[AGENT][NEUTRAL] OK. And what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, what's a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, is it for 3 different patients?
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] And what's the date of service in charge?
[CUSTOMER][NEUTRAL] Uh, [PII] and it's $3,443.24.
[AGENT][NEUTRAL] 24 cents?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, we're needing a copy of the primary um explanation of benefits. Um, I show that this claim was processed.
[AGENT][NEUTRAL] On the [PII].
[AGENT][NEUTRAL] And I have the claim number if you would like the claim number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh yes, please.
[AGENT][NEUTRAL] That number is 354-827-0.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I have the fax number and everything um and just attention to the claims department right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, I'll get that sent over.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] And I'm ready for the next policy number.
[CUSTOMER][NEUTRAL] It is 02506452 M for Mike L7.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] And what's the date of service in charge?
[CUSTOMER][NEUTRAL] [PII] and it's $4,422.08.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We're needing a copy of the primary explanation of benefits. Is that an emergency room visit?
[CUSTOMER][NEUTRAL] Uh, yes.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Alright, I show the claim number is 355.
[AGENT][NEUTRAL] 426 5.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] And I'm ready for the next policy number.
[CUSTOMER][NEUTRAL] OK, 02344570, M for Mike L 7.
[AGENT][NEUTRAL] And the patient's name?
[CUSTOMER][NEUTRAL] Patient's name is [PII].
[AGENT][NEUTRAL] And what's your date of service?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] And the bill amount?
[CUSTOMER][NEUTRAL] The bill amount is $4,981.12.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the policy number is 254-4986.
[AGENT][NEUTRAL] It's the correct, that's the correct policy number?
[CUSTOMER][NEUTRAL] Um, OK.
[AGENT][NEUTRAL] And I do not show this claim on file for [PII] for data service [PII], 4,981.20.
[CUSTOMER][NEUTRAL] OK, uh, I'll get that one resubmitted over then. Uh, is there a timely filing limit?
[AGENT][NEUTRAL] There's no timely filing to submit the claim?
[CUSTOMER][NEUTRAL] OK, and I just need uh your name again and a reference number please.
[AGENT][NEUTRAL] You'll use my name in today's date is your reference for today's call [PII] and any other questions, [PII]?
[CUSTOMER][POSITIVE] No, that's it thank you so much.
[AGENT][POSITIVE] Uh huh, you're welcome. Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.