AccountId: 011433970860
ContactId: 11218f9c-855e-4324-9bd7-578e82d5b779
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 183940 ms
Total Talk Time (AGENT): 90540 ms
Total Talk Time (CUSTOMER): 69336 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/11218f9c-855e-4324-9bd7-578e82d5b779_20250228T23:12_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, I just wanted to ask a quick question. I wanted to see if a certain procedure code was covered under this patient's um plan.
[AGENT][NEUTRAL] OK, I could take a look at those benefits for you. uh, what was your name? I'm sorry.
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK, [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Of course it'll be [PII].
[AGENT][NEUTRAL] OK, thank you and then do you have the policy number?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Would the member ID be fine?
[AGENT][POSITIVE] Oh yeah, that should work.
[CUSTOMER][NEUTRAL] Yes, OK. It'll be um 02465237.
[AGENT][NEUTRAL] OK, thank you and what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] It would be [PII]. Date of birth would be [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that [PII]. Uh, so this policy is active. Effective date was [PII], and we just had a specific procedure code we were needing to see uh if it was covered under this policy.
[CUSTOMER][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, give me just a moment let me get that pulled up and if you don't have it, I can send you the fax back that shows all of the covered procedures and benefit information.
[CUSTOMER][POSITIVE] Yeah, that'd be great as well.
[AGENT][NEUTRAL] OK, alrighty, I do have that up. um, what was that procedure code?
[CUSTOMER][NEUTRAL] Um, it is 0367.
[AGENT][NEUTRAL] That is not going to be a covered procedure under this policy.
[CUSTOMER][NEUTRAL] OK, OK. Perfect. Then I will go ahead and let the patient know. And then I do have just one more procedure code as well. Um, I know that it is covered. I just wanted to check the history on it as well. It's for 11/10.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] 1110. OK, give me just a moment. This was for [PII]?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I don't have any history, uh, for 11:10 on file at all.
[CUSTOMER][NEUTRAL] OK perfect then I will go ahead and make a note of that as well. By any chance, can I just get a reference number please?
[AGENT][NEUTRAL] For [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure, um, did you want any, uh, can I get that fax number from you first so I can go ahead and get this sent to you?
[CUSTOMER][NEUTRAL] Yeah, of course. Let me go ahead and give it to you. It would be 469.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] 9669925.
[AGENT][NEUTRAL] OK, appreciate it. You should get that here in maybe 1015 minutes. Um, reference number would just be my first name, last initial, and today's date and so my name is spelled [PII] Last initial is [PII] Was there anything else I could help you with, [PII]?
[CUSTOMER][POSITIVE] That would be everything, thank you so much.
[AGENT][POSITIVE] Alright well thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] You too thank you so much.
[AGENT][POSITIVE] Thank you bye bye