AccountId: 011433970860
ContactId: 2c88d257-72cb-4845-b856-e85ef27098dc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 224029 ms
Total Talk Time (AGENT): 79269 ms
Total Talk Time (CUSTOMER): 85888 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/06/2c88d257-72cb-4845-b856-e85ef27098dc_20250506T19:45_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] calling from the Emory Clinic. I'm here for claim status.
[AGENT][NEUTRAL] OK, [PII], I'm happy to check on the claim. What's the policy number?
[CUSTOMER][NEUTRAL] Yeah. Policy number is 022-06104.
[AGENT][POSITIVE] Thank you. One moment.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah. Patient's name, [PII]. Date of birth, [PII].
[AGENT][NEUTRAL] Thank you. And then what's the date of service?
[CUSTOMER][NEUTRAL] You're welcome. Yeah, date of service [PII].
[AGENT][NEUTRAL] Filled them out?
[CUSTOMER][NEUTRAL] Total amount $161.70.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you for your patience on that. So we did receive a claim for the state of service. Claim was received [PII].
[AGENT][NEUTRAL] Claim was denied on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, it looks like it was a denied service. Benefits payable under the certificate are limited to scheduled benefits. This was not a covered loss under the member's plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you very much. Can I have the claim number for this claim?
[AGENT][NEUTRAL] 356-403-5.
[CUSTOMER][NEUTRAL] OK. Thank you very much. And uh is there any patience responsibility in this claim?
[AGENT][NEUTRAL] We're not able to advise on patient responsibility that's up to the facility or provider.
[CUSTOMER][NEUTRAL] OK, thank you very much. And yep, that's all I wanted to check. And regarding this claims EOB, uh, how can I obtain EOB? Could you please fax this EOBO?
[AGENT][NEUTRAL] What's a good fax number?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII]. Again.
[CUSTOMER][NEUTRAL] [PII]. And please attention it to my name. My name is spells as [PII]
[CUSTOMER][NEUTRAL] And the initial to my last name is [PII].
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Alright, [PII], that's on its way. It should be there in about 5 minutes. Is there anything else I can check on for you?
[CUSTOMER][NEUTRAL] Thank you, sir. And can I have a call reference, please?
[AGENT][NEUTRAL] Call reference is my name with my last initial, then today's date. My name again is [PII], that's [PII] [PII], then today's date.
[CUSTOMER][POSITIVE] OK, got it. Thank you very much.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][POSITIVE] Have a great day. Bye.
[AGENT][NEUTRAL] Mhm. Bye bye.