AccountId: 011433970860
ContactId: 0fcad189-7d5d-48d8-aa36-808ca3041c91
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 288779 ms
Total Talk Time (AGENT): 118121 ms
Total Talk Time (CUSTOMER): 60805 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/17/0fcad189-7d5d-48d8-aa36-808ca3041c91_20250617T20:39_UTC.wav
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[AGENT][NEUTRAL] Good afternoon, thank you for calling ATL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello, yes, this is [PII] with APL. How may I assist you?
[CUSTOMER][NEUTRAL] Yes ma'am, I need to be connected to the provider line for medical services.
[AGENT][NEUTRAL] What type of information are you needing?
[CUSTOMER][NEUTRAL] Eligibility, well, yes, eligibility and um possibly just an update on the allowance that's left over.
[AGENT][POSITIVE] OK, sure, I can assist you. And may I have your name and a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Of course my name is [PII], and the callback number is [PII].
[AGENT][NEUTRAL] Thank you. May I have the name of the facility for my notes, Miss [PII]?
[CUSTOMER][NEUTRAL] Valley Cataract and Retina Clinic.
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, so allow me just a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Policy number is going to be 1869088.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] date of birth [PII].
[AGENT][NEUTRAL] Thank you, Ms. [PII]. And since that you say you need eligibility. We have an effective date of [PII]. It is active at the moment and this is the secondary supplemental plan to the major medical and you said you need remaining balance.
[CUSTOMER][POSITIVE] Yes, for uh the benefit allowance.
[AGENT][NEUTRAL] Is this for an office visit or what type of service is being rendered?
[CUSTOMER][NEUTRAL] Um, this will be for an office visit with a specialist.
[AGENT][NEUTRAL] OK, bear with me just a second. Let me go ahead and look at the benefits for office visit.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It's gonna be a minute. I'm waiting on the documents.
[AGENT][NEUTRAL] OK, so this one doesn't cover the office visit. It will only cover procedures done in office, but not the office visit.
[CUSTOMER][NEUTRAL] OK, so office is not covered?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] What about uh diagnostic medical?
[AGENT][NEUTRAL] Yes, any procedures or treatment done in office that will be considered under the outpatient maximum, which is 2550 per cover person per calendar year.
[CUSTOMER][NEUTRAL] And what is the remaining now?
[AGENT][NEUTRAL] OK, let me check on that and this is not a guarantee of payment, just a verification of coverage and that's just for its claim.
[AGENT][NEUTRAL] And let's see, she has to use 17547.
[AGENT][NEUTRAL] 17547.
[CUSTOMER][NEUTRAL] 17547 has been met.
[AGENT][NEUTRAL] Yes. Mhm. So she has remaining $2,374.53 as of today.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm sorry, what was the remaining?
[AGENT][NEUTRAL] 2374.53.
[CUSTOMER][NEUTRAL] 53
[CUSTOMER][NEUTRAL] OK, um, and I'm sorry, what was your name?
[AGENT][NEUTRAL] My name is [PII]. That's [PII]. Is there anything else I can help you with today, Miss [PII]?
[CUSTOMER][NEUTRAL] Uh, yes, if you have a reference number.
[AGENT][NEUTRAL] We don't. You can use my name in these things.
[CUSTOMER][POSITIVE] OK perfect thank you so much ma'am you have a wonderful day.
[AGENT][POSITIVE] You as well thank you for calling. Bye bye.