AccountId: 011433970860
ContactId: 0595577b-2c1b-43cf-9318-5494ad857540
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 390459 ms
Total Talk Time (AGENT): 120973 ms
Total Talk Time (CUSTOMER): 85999 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/05/0595577b-2c1b-43cf-9318-5494ad857540_20250205T20:38_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, ma'am. My name is [PII]. I'm calling on behalf of Emory University Hospital, and I needed to check the status of the claim.
[AGENT][NEUTRAL] OK Miss [PII], I can help you with the claim. Can you please give me your callback number, ma'am, just in case your call gets disconnected?
[CUSTOMER][NEUTRAL] Yes, callback number is [PII].
[AGENT][POSITIVE] Thank you so much, Ms. [PII]. What is the patient's name?
[CUSTOMER][NEUTRAL] Patient's first name is [PII]. Last name [PII].
[AGENT][NEUTRAL] And what is [PII]'s date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you and then also his policy number.
[CUSTOMER][NEUTRAL] I have 02206104.
[AGENT][NEUTRAL] OK, let me pull that policy up for us real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, thank you. And then what is [PII]'s data service?
[CUSTOMER][NEUTRAL] That would be [PII].
[AGENT][NEUTRAL] And the charge amount please?
[CUSTOMER][NEUTRAL] $4,923.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And you said you were calling from Emory University, is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, Miss [PII], I'm gonna put you on a brief hold. I'm gonna look up that claim for you and I will be right back.
[CUSTOMER][NEUTRAL] All right. You are on hold.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] 4000.
[AGENT][NEUTRAL] 9:23. Let's make sure there's not another one.
[AGENT][NEUTRAL] But
[AGENT][NEUTRAL] 486 7.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hi Ms. [PII], this is [PII] back with you again. I did find the claim for you. Um, the claim number is 3534867.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I do show that the claim was paid $150 with check number 2,015,710.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Once that check was paid with $150 the maximum benefit payable for the data service was met.
[CUSTOMER][NEUTRAL] OK, max pay amount.
[CUSTOMER][NEUTRAL] So that was all that the claim allowed max paid amount.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] And there was no patient liability?
[AGENT][NEUTRAL] We don't give the patient.
[AGENT][NEUTRAL] Responsibility because that's determined by the provider?
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK, we did receive the payment. I was just making sure because it seemed really small compared to the total charge and I had to make sure.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes ma'am, I understand.
[CUSTOMER][NEUTRAL] All right. Mhm.
[CUSTOMER][NEUTRAL] Uh, and they didn't upload the EOB for me to look at, so I was like, well, I gotta call and make sure.
[AGENT][NEUTRAL] Yes ma'am, I understand.
[AGENT][NEUTRAL] Yes, um, the allowable amount for ER is $150 so once it was paid, the $150 it it matched the benefit for that data service.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] OK, I have one for you.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][POSITIVE] I appreciate that very much. I think I just need a reference number if you have one.
[AGENT][NEUTRAL] Yes ma'am, you can use my name. It's [PII] and today's date.
[CUSTOMER][POSITIVE] All right, I appreciate that again.
[AGENT][POSITIVE] Well, we appreciate you, Ms. [PII]. Thank you so much for calling APL. I hope you have a good rest of your day.
[CUSTOMER][POSITIVE] All right, thank you. You as well.
[AGENT][POSITIVE] Thank you, ma'am. Bye-bye.
[CUSTOMER][NEUTRAL] Bye-bye.