AccountId: 011433970860
ContactId: 2f8e5d7b-11a6-4927-b868-fa43cd0ac092
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 219399 ms
Total Talk Time (AGENT): 86674 ms
Total Talk Time (CUSTOMER): 63670 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/2f8e5d7b-11a6-4927-b868-fa43cd0ac092_20250313T21:53_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hello, I'm [PII] calling from AmeriClinic. I want to check claim status.
[AGENT][NEUTRAL] Sure, I could check on a claim for you. uh, [PII], can I get a good call back number from you first in case we're disconnected please?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, that is [PII].
[AGENT][NEUTRAL] OK, thank you. And do you have the policy number?
[CUSTOMER][NEUTRAL] Yeah, I have the policy number is, one moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, that is 022-06104.
[AGENT][NEUTRAL] OK and uh what was the name and date of birth for the insured please?
[CUSTOMER][NEUTRAL] Yeah, the name is [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that then uh what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Date of service is [PII].
[AGENT][NEUTRAL] OK, do you have that bill amount?
[CUSTOMER][NEUTRAL] Yeah, one moment.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yeah. That is $349 349.
[AGENT][NEUTRAL] 249 OK thank you one moment please.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Was this for uh is it the Emory clinic?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alrighty, so we did receive this claim then we were unable to pay a benefit as any puncture is not covered under this policy.
[AGENT][NEGATIVE] And it does not provide any benefits for the treatment of alcohol and or drug abuse.
[CUSTOMER][NEUTRAL] OK. Uh-huh.
[CUSTOMER][NEUTRAL] Is there any patient responsibilities?
[AGENT][NEGATIVE] We do not say what is patient responsibility that would be up to the provider we were unable to pay a benefit though.
[AGENT][NEUTRAL] And if you'd like I can send you a copy of this fax or excuse me of the uh EOB.
[CUSTOMER][NEUTRAL] Sir, can you repeat one more time? What's the reason?
[AGENT][NEUTRAL] Oh, sure. So enny puncture is not covered under this policy, nor is the treatment of alcohol or drug abuse.
[CUSTOMER][NEUTRAL] OK. And
[CUSTOMER][NEUTRAL] And that is not a patient responsibility, no?
[AGENT][NEUTRAL] We do not say what is patient responsibility, that is up to the provider.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Can I have your name and conference number?
[AGENT][NEUTRAL] Sure, reference number would just be my first name, last initial, and today's date. Uh, so my name is spelled [PII] Was there anything else I could help you with?
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Your name is [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] What's the conference number, your name, ma'am?
[AGENT][NEUTRAL] It's my first name, last initial, and today's date. My last initial is A.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yeah, thank you, [PII] for you mentioned, yeah, that's all.
[AGENT][POSITIVE] Of course, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.