AccountId: 011433970860
ContactId: 0b9935d3-d7ba-47ed-bb52-d4d369baaab1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 260269 ms
Total Talk Time (AGENT): 106109 ms
Total Talk Time (CUSTOMER): 65969 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/0b9935d3-d7ba-47ed-bb52-d4d369baaab1_20250416T13:42_UTC.wav
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[AGENT][POSITIVE] And thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Um, I'm sorry, I didn't catch your name.
[AGENT][NEUTRAL] Um, it's [PII].
[CUSTOMER][NEUTRAL] [PII], OK. Hi, [PII], uh, I'm [PII]. I'm calling from Jenny Stewart Medical Center, and I have a member I need to verify eligibility and benefits.
[AGENT][NEUTRAL] Yes, ma'am. Mhm.
[AGENT][POSITIVE] I'm sure [PII] I can assist you with benefits. Um, first, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] OK. Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] The policy number is
[CUSTOMER][NEUTRAL] 02584454
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII], and her date of birth is [PII].
[AGENT][NEUTRAL] Thank you and just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII] and the policy is still active. And you, you said you're calling from hospital. Is this for outpatient benefits?
[CUSTOMER][NEUTRAL] Yes, the patient's having a nuclear medicine testing.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, thanks for your patience. Um, I'm showing that under her policy for outpatient services for the facility charges, we'll cover up to $500.
[AGENT][NEUTRAL] And then for the procedure or what she's having done, we'll cover up to 250. This is a limited hospital indemnity plan, but there is some outpatient benefits.
[CUSTOMER][NEUTRAL] Memorial Hospital indemnity.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so a total of 750, is that what you're saying or a total of 250?
[AGENT][NEUTRAL] Um, for the facility charges, 500 and then for the visit for what she's having done, we'll cover up to 250.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Facility charges and procedures.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, alright, and has she met any of that or is that her?
[CUSTOMER][NEUTRAL] Procedure.
[AGENT][NEUTRAL] And let's see, has she met any because for the procedure, we only cover that once a year. And well, the, for the facility, I'm sorry, we covered that once a year and for the procedure, she gets 2 per calendar year.
[CUSTOMER][POSITIVE] And be good.
[AGENT][NEUTRAL] And they're both available. She hasn't used them yet this year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] OK. And is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Um, no, ma'am, is there a reference number for this call?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. And again, my name is [PII]. Um, my last initial is [PII], and today's date.
[AGENT][NEUTRAL] Will be your reference number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And [PII], is that spelled [PII] V I [PII]?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] Alright, miss, that's all I needed. Thank you so much.
[AGENT][POSITIVE] OK. Thank you, [PII] for calling ATL. You have a great rest of your day. Mm bye.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] OK thanks.