AccountId: 011433970860
ContactId: 997b9eb5-99cd-4670-bbd0-451a2e1e0cbf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 218479 ms
Total Talk Time (AGENT): 81446 ms
Total Talk Time (CUSTOMER): 118364 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/25/997b9eb5-99cd-4670-bbd0-451a2e1e0cbf_20250425T18:48_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Uh, yes, uh, my name is [PII]. I'm calling on behalf of, um, Emory Saint Joseph's Hospital of Atlanta. I had a question on a claim.
[AGENT][NEUTRAL] OK, sure, I can assist you with claims Mr. [PII], and may I have
[CUSTOMER][NEUTRAL] What, what's your name again?
[AGENT][NEUTRAL] My, my name is [PII].
[AGENT][NEUTRAL] And may I have a callback number just in case we get disconnected, Mr. [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Uh, the ID number?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] 02468294.
[AGENT][NEUTRAL] Mm thank you. May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Name is um the last name is [PII] first name um let's see, date of birth is uh.
[CUSTOMER][NEUTRAL] [PII] was yesterday. Wow, [PII].
[AGENT][NEUTRAL] All right, thank you. OK, and what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Data service was [PII] for $5,769.23.
[AGENT][POSITIVE] Perfect, thank you. Let me see if I can find this claim for you. One moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You had a question about this claim here. Um, I did get the information. It was paid for $200.
[AGENT][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] We were told that the um claim claim number 3577433.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] We're told that the claim was part of the part it was paid for part of the member's Hospital Limited indemnity plan.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Now my question was, is that the originally.
[CUSTOMER][NEUTRAL] We had um
[CUSTOMER][NEUTRAL] Expected uh lot amount was $2,307.69. Are you saying because it's a, it's a limited indemnity.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Uh, doesn't mean that the remaining balance is not covered?
[CUSTOMER][NEUTRAL] Or is it patient responsibility?
[AGENT][NEUTRAL] Well
[AGENT][NEUTRAL] We cannot really tell you what to do with the claim. Um, the only thing I can tell you this is up to the provider's discretion. Um, we don't have any contractual involvement because it is a limited policy. We don't know if he has any other policies out there, OK? But yeah, the flat amount, it was $200.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Indemnity amount was 200.
[CUSTOMER][NEUTRAL] OK, in that case, in that case, we'll let, I'll let, I'll let the other people decide on this then, uh, I'll just make a note of that. OK, I just wanted to make sure that it's all I can do with it, so let, we'll let the others figure it, figure it out. OK. I just want to make sure about this.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] This side, yeah.
[AGENT][POSITIVE] Sure, no problem. You're welcome.
[CUSTOMER][POSITIVE] Thank you very much. Do you have a reference number for this call?
[AGENT][NEUTRAL] We don't have reference numbers you can use my name in today's date.
[CUSTOMER][POSITIVE] OK, all right, thank you very much. I appreciate it.
[AGENT][NEUTRAL] Mm
[AGENT][POSITIVE] You're welcome. You're welcome and thank you for calling ATL. Have a good weekend, [PII].
[CUSTOMER][POSITIVE] You too thank you bye now.
[AGENT][POSITIVE] Thank you. You're welcome. Bye-bye.