AccountId: 011433970860
ContactId: f3869a90-6c67-48af-b4e1-e8cc9058a029
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 235289 ms
Total Talk Time (AGENT): 85487 ms
Total Talk Time (CUSTOMER): 84788 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/f3869a90-6c67-48af-b4e1-e8cc9058a029_20250121T21:47_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from Ameri Clinic.
[AGENT][NEUTRAL] OK, I'm sorry, I couldn't hear you. Can you repeat your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK, and [PII], um, you said you're calling from Emory Clinic?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] All right. And may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] What was the rest?
[CUSTOMER][NEUTRAL] No, it's [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so [PII]. Thank you. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] 02033200.
[AGENT][POSITIVE] Thank you. And how may I assist you today?
[CUSTOMER][NEUTRAL] Claiming status.
[AGENT][NEUTRAL] OK, can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII]. Date of birth, [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service for the claim you'd like me to check on?
[CUSTOMER][NEUTRAL] OK. The date of service is [PII].
[AGENT][NEUTRAL] And the total bill amount?
[CUSTOMER][NEUTRAL] The total bill amount is?
[CUSTOMER][NEUTRAL] Let me check that.
[CUSTOMER][NEUTRAL] $618.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And can you verify your tax ID?
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you for that, and I'm showing that we received the claim on [PII].
[AGENT][NEUTRAL] That claim number is 352.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 668 7.
[AGENT][NEUTRAL] And on [PII], the claim was denied as office visits are not covered on this policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, can you provide me the
[CUSTOMER][NEGATIVE] Denied the amount.
[AGENT][NEUTRAL] The total bill was $618.
[CUSTOMER][NEUTRAL] Is there, OK, OK.
[CUSTOMER][NEUTRAL] Is there any PRM? No, right?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Is there any patient responsibility amount?
[AGENT][NEUTRAL] We don't determine patient responsibility because we're not the major medical insurance company, um, but we did not pay out on this claim, so the outstanding balance is the total bill, 618.
[CUSTOMER][NEUTRAL] OK. Thank you. Uh, can you provide me the call reference number for this call?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name and today's date. The first initial of my last name is [PII].
[CUSTOMER][NEUTRAL] First name, you?
[AGENT][NEUTRAL] My name is [PII]
[CUSTOMER][NEUTRAL] Uh, OK.
[CUSTOMER][POSITIVE] Today's date, right? OK. OK, [PII]. Thank you. Have a good day. Bye-bye.
[AGENT][POSITIVE] You're very welcome and thanks for calling APL. Bye-bye.