AccountId: 011433970860
ContactId: 0a30718d-a6f5-4c98-82d9-8d8153b8728d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 169679 ms
Total Talk Time (AGENT): 92626 ms
Total Talk Time (CUSTOMER): 63694 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/0a30718d-a6f5-4c98-82d9-8d8153b8728d_20250325T15:13_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] You said [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK, [PII], I'm calling you from an ophthalmologist's office, and I want to know if this patient's APO covers copays.
[AGENT][NEUTRAL] Sure, I can take a look at those benefits, uh, and see what kind of policy that is if that would apply to copays. What was your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] That was [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK and then can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Got it. Thank you. And then, uh, do you have the policy number?
[CUSTOMER][NEUTRAL] The policy number is 01659488ML8.
[AGENT][NEUTRAL] OK, and uh what was the name and date of birth for the patient, please?
[CUSTOMER][NEUTRAL] It's [PII] [PII].
[AGENT][NEUTRAL] Perfect. OK, thank you for verifying that. Um, so this policy is active. Effective date was [PII], and so this is a secondary medical policy. It is designed to help with copay, deductible and co-insurance after major medical pays.
[CUSTOMER][NEUTRAL] OK, so tell me again, OK, so he's coming in for, uh, for a specialist office visit, right? So do you guys cover the specialist copay or no?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, let me.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Let me verify that. Give me just a moment. Um, so as it is secondary medical, um, again, it is very dependent on uh major medical, uh, and they all are a bit different. Give me just a moment.
[AGENT][NEUTRAL] OK, and of course I will let you know uh verification of coverage is not a guarantee of payment for claims. So for this particular policy, uh, office visits are covered and, uh, as long as, excuse me, as well as treatment received in office.
[CUSTOMER][NEUTRAL] Also.
[CUSTOMER][NEUTRAL] Treatments received.
[CUSTOMER][NEUTRAL] Inside office.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So OB visits are covered. Also treatments received inside office.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, let me have a reference number to the call.
[AGENT][NEUTRAL] Sure, that 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, [PII]?
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] And then today's date, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] No, that's it. Thank you so much.
[AGENT][POSITIVE] OK, yeah, thanks for calling. Have a great rest of your day.