AccountId: 011433970860
ContactId: f5a59c41-3e92-468b-b97f-b707a041b2e7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 236389 ms
Total Talk Time (AGENT): 92629 ms
Total Talk Time (CUSTOMER): 86339 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/f5a59c41-3e92-468b-b97f-b707a041b2e7_20250321T16:58_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, [PII], this is [PII] calling from Nicholas Children's Hospital. My name is [PII] and this call has been made to know a claim status for a patient.
[AGENT][NEUTRAL] [PII], what is your callback number?
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] OK, just hold on. It is [PII].
[AGENT][NEUTRAL] What is the policy number?
[CUSTOMER][NEUTRAL] Uh, the policy number is just give me a second.
[CUSTOMER][NEUTRAL] Policy number is 02509838.
[AGENT][NEUTRAL] OK, and to repeat and confirm that, [PII], I have that as 02509838 for the policy number.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Verify the patient's name and date of birth. Thank you.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] The patient name is [PII].
[CUSTOMER][NEUTRAL] And date of birth is [PII].
[AGENT][NEUTRAL] Thank you very much. And again, you're calling in regards to claim status. One moment please, [PII]. And also to let you know you can check claim status by visiting our secure portal at [PII] and on that website you'll be able to obtain an you'll be if you need one. What's that date of service and the total charge amount?
[CUSTOMER][NEUTRAL] I actually
[CUSTOMER][NEUTRAL] OK, so the date of service is [PII].
[CUSTOMER][NEUTRAL] And total charges on claim are $1,401.94.
[AGENT][NEUTRAL] OK, so let me just repeat that. That was [PII] $1,401.94.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, thank you. One moment please.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Almost done, thank you for your patience.
[AGENT][NEUTRAL] OK, it shows that the claim was received and it denied as stating benefits are payable only if the major medical insurance provider provides benefits. Um, did you receive an updated EOB and submit that into us?
[CUSTOMER][NEUTRAL] Sure, so you need the primary OP.
[AGENT][NEUTRAL] Correct, we need one that shows that charges were applied to the deductible, co-pay or co-insurance, yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure. And can you tell me the pro uh sorry, can you tell the claim number first?
[AGENT][NEUTRAL] Of course, the claim number shows 3567736.
[CUSTOMER][NEUTRAL] 356-7736. Just hold on for a second. Let me put it on the portal so that I can get the other details. Actually, the thing is that we are, we don't have access to the patient SSN number, and while looking into a provider portal, it asks for the last four digits of the SSN. So I need to make the call to just get the claim number so that I can just look into this.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Just hold on for a second. Let it is searching the claim. OK, so I got this claim.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Can you provide a reference number also?
[AGENT][NEUTRAL] We do not provide reference numbers, [PII]. However, you can use my name in today's date. The last initial is [PII], again, first name is [PII].
[CUSTOMER][NEUTRAL] The last thing
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Thank you, [PII], for the assistance that you provided and have a great day and a great weekend ahead.
[AGENT][POSITIVE] You as well, [PII], and thank you for calling APL. Take care bye.
[CUSTOMER][NEUTRAL] But.