AccountId: 011433970860
ContactId: 1218e8bf-e858-4048-97d3-90bd3e552d60
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 166919 ms
Total Talk Time (AGENT): 95771 ms
Total Talk Time (CUSTOMER): 37312 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/1218e8bf-e858-4048-97d3-90bd3e552d60_20250527T15:39_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, I was checking the benefits of for this patient.
[AGENT][NEUTRAL] Um, yes, ma'am. I can assist you with benefits. Um, first, could I get your name and a good callback number?
[CUSTOMER][NEUTRAL] I mean,
[CUSTOMER][NEUTRAL] Mhm [PII] and uh telephone number is [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] 02462932
[AGENT][NEUTRAL] OK. Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Can you do like Tuesday.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] And just let me advise you that verification of coverage does not guarantee payment of claims. Um, I'm showing the effective date on this policy was [PII]. The policy is still active. And is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Outpatient um ambulatory center.
[AGENT][POSITIVE] OK. Thank you. In one moment. Those benefits are coming up.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, for outpatient, we cover up to $4500 per calendar year and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim, but there is a $1500 deductible that needs to be met first.
[CUSTOMER][NEUTRAL] Has she met any of that deductible yet?
[AGENT][NEUTRAL] He's see.
[AGENT][NEUTRAL] OK. Yes, ma'am. She has met her deductible and she's used some of her benefits. Let's
[CUSTOMER][POSITIVE] Good
[AGENT][NEUTRAL] She's used $2,872.31 of the benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And can you tell me um if pre-start is required on this code?
[AGENT][NEUTRAL] Um, no, ma'am. Since this is secondary gap insurance, no pre-cert is required because we go by the primary insurance guidelines.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][POSITIVE] Alright, that's what I needed to know.
[AGENT][POSITIVE] OK. Well, I thank you for calling APL [PII]. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] Um, just the reference number for this call.
[AGENT][NEUTRAL] Um, so the reference number, you can use my name and today's date. My name is Evie. It's spelled E V I E. Last initial M like [PII], and today's date.
[CUSTOMER][POSITIVE] All right thank you so much.
[AGENT][POSITIVE] OK. Thank you again for calling ATL. You have a great rest of your day. Mm bye.
[CUSTOMER][POSITIVE] You too thank you bye bye.
[AGENT][NEUTRAL] OK.