AccountId: 011433970860
ContactId: 6b7e9102-9690-420d-9d4f-8f12c6fae0b2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 261358 ms
Total Talk Time (AGENT): 93140 ms
Total Talk Time (CUSTOMER): 82143 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/01/6b7e9102-9690-420d-9d4f-8f12c6fae0b2_20250401T18:21_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm [PII] calling from Memory clinic. I want to check the status.
[AGENT][NEUTRAL] Sure, I can check an account for you. Uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, that is [PII].
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] One moment. The policy number is going to be 02206104.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] Yeah, the name is [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that uh what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Yeah, the date of service is [PII].
[AGENT][NEUTRAL] OK, and then, uh, do you have that bill amount?
[CUSTOMER][NEUTRAL] Yeah, that is $497 even. 497.
[AGENT][NEUTRAL] Got it. OK, thank you. One moment, please.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] I'm sorry, [PII], what was the name of the provider's office this was with?
[CUSTOMER][NEUTRAL] Yeah, the Emory University Hospital.
[AGENT][NEUTRAL] Got it. OK, thank you for verifying that. Give me just a moment.
[AGENT][NEUTRAL] OK, so we did receive this claim then. Uh, we were unable to pay a benefit as treatment in an outpatient hospital is not covered under this policy.
[CUSTOMER][NEUTRAL] Mm. Can I have the claim number?
[AGENT][NEUTRAL] Sure, that's 356-2153.
[CUSTOMER][NEUTRAL] 3562153
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEGATIVE] And claim is denied, no.
[AGENT][NEUTRAL] That's correct and if you'd like I can send you a copy of this EOB.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yeah. Uh, one more thing. Can you, uh, one more thing, can you repeat one more time the reason?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Yes, so under this policy, treatment in an outpatient hospital is not covered.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Uh, then can you send the UBI fax to us?
[AGENT][NEUTRAL] Of course. What was that fax number?
[CUSTOMER][NEUTRAL] Yeah, that is 214.
[CUSTOMER][NEUTRAL] [PII]. [PII]. yeah, attention to my name, [PII] and last name is.
[AGENT][NEUTRAL] OK, I'm going to
[AGENT][NEUTRAL] Got it.
[AGENT][NEUTRAL] OK, then.
[AGENT][NEUTRAL] What was the last initial? I'm sorry.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Got it. OK, um, alright, I will get that sent to you. You should get it here within about 10 minutes or so. Was there anything else I could help you with then?
[CUSTOMER][NEUTRAL] I don't know. Can I have your name and conference number?
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date. Uh, so my name is spelled [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Your name is [PII]?
[AGENT][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK. Thank you, [PII], for the information. Yeah, that's all. Have a great day.
[AGENT][POSITIVE] Sure, yeah, thanks for calling APL. You too. Bye bye.
[CUSTOMER][NEUTRAL] You too. Bye-bye. Bye-bye.