AccountId: 011433970860
ContactId: 498ca07a-8637-4118-bf52-5eff8d91dabe
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 361200 ms
Total Talk Time (AGENT): 115279 ms
Total Talk Time (CUSTOMER): 116754 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/498ca07a-8637-4118-bf52-5eff8d91dabe_20250523T14:01_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling EPL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yes, I'm sorry, your name?
[AGENT][NEUTRAL] My name is [PII]. Um, it's spelled [PII] and my last initial is [PII].
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling from East Georgia Regional Medical Center calling to check claim status on a patient.
[AGENT][NEUTRAL] I'm sure to one that I can assist you with claim status. Um, first, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure. It's going to be [PII], no extension.
[AGENT][NEUTRAL] OK. Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] I have 02469142.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII], date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. Now I need the date of service and bill charges on the claim.
[CUSTOMER][NEUTRAL] Data service is going to be 1125. Total charge is going to be $8,449.50.
[AGENT][NEUTRAL] OK, one moment please. I'm still waiting on my system.
[CUSTOMER][POSITIVE] Take your time.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK. Yes, ma'am. I'm showing that we received this claim on [PII].
[AGENT][NEUTRAL] It processed on [PII].
[AGENT][NEUTRAL] The claim number is 3553217.
[AGENT][NEUTRAL] And it paid out for $150.
[AGENT][NEUTRAL] And it paid out this amount because under this policy for ER visits, um, we cover up to $150 per visit.
[CUSTOMER][NEUTRAL] So it's a limited plan?
[AGENT][NEUTRAL] Yes, ma'am, it is.
[CUSTOMER][NEUTRAL] OK, so she said claim paid $150. She said that this is a limited plan. And what's that, um,
[CUSTOMER][NEUTRAL] Do you have the EFT number?
[CUSTOMER][NEUTRAL] And the check information?
[AGENT][NEUTRAL] Well, it was a single check and the check number is
[AGENT][NEUTRAL] 20234252.
[AGENT][NEUTRAL] And it was mailed to the address on the claim.
[CUSTOMER][NEUTRAL] The address that's on the claim.
[AGENT][NEUTRAL] Right, the [PII].
[AGENT][NEUTRAL] In [PII].
[CUSTOMER][NEUTRAL] That's not our address.
[AGENT][NEUTRAL] Wait one moment.
[CUSTOMER][NEUTRAL] Is that OK, so let me ask you a question, because I called yesterday and I spoke to another, another rep, um.
[CUSTOMER][NEUTRAL] And she told me that the claim paid $150 but they sent the payment to the patient.
[AGENT][NEUTRAL] OK one moment.
[AGENT][NEUTRAL] Yes, I'm showing that this uh payment was sent to the patient.
[CUSTOMER][NEUTRAL] OK. 25.
[CUSTOMER][NEUTRAL] Uh check number 20234252. So that was paid to the patient, correct?
[AGENT][NEUTRAL] Yes, ma'am. That's correct. I just looked up the check. It was paid to the patient.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is there any way we could get a copy of that EOP?
[CUSTOMER][NEUTRAL] Showing that you guys paid 0? OK.
[AGENT][NEUTRAL] Um, yes, ma'am.
[AGENT][NEUTRAL] What's your fax number? I could fax it to you.
[CUSTOMER][NEUTRAL] OK, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And to whose attention?
[CUSTOMER][NEUTRAL] Um, [PII]
[AGENT][NEUTRAL] OK, and that fax number again is [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK. I'm I'm fax you a copy of the explanation of benefits. Um, is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Um, no, ma'am. So we can build a patient.
[AGENT][POSITIVE] Yes, ma'am, that's correct.
[CUSTOMER][POSITIVE] OK, no problem.
[CUSTOMER][NEUTRAL] All right, all right, and let's see.
[CUSTOMER][NEUTRAL] OK, no problem. And is there a reference number for our call?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date.
[CUSTOMER][NEUTRAL] OK. And that's E V I E?
[AGENT][NEUTRAL] Yes, ma'am. And my last initial is [PII] like [PII].
[CUSTOMER][POSITIVE] Thank you so much, my dear. You have a wonderful blessed day. Stay safe and a happy holiday.
[AGENT][NEUTRAL] Same to you, [PII]. Thank you for calling APL. bye.
[CUSTOMER][NEUTRAL] Mhm. Bye-bye.
[AGENT][POSITIVE] Thank you.