AccountId: 011433970860
ContactId: 18670622-a0ca-4b64-99eb-6cd5bf5fea68
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 201860 ms
Total Talk Time (AGENT): 95359 ms
Total Talk Time (CUSTOMER): 70678 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/23/18670622-a0ca-4b64-99eb-6cd5bf5fea68_20250623T18:29_UTC.wav
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[AGENT][POSITIVE] Thank you for contacting ATL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I'm [PII]. I'm calling from the provider's office. How are you doing today?
[AGENT][NEUTRAL] I'm fine, [PII]. How are you?
[CUSTOMER][POSITIVE] I'm good too, thank you so much for asking.
[AGENT][NEUTRAL] Hello?
[CUSTOMER][POSITIVE] Uh, I'm good. How about you? How are you doing today?
[AGENT][NEUTRAL] Uh, yes, I'm, I'm fine, [PII]. How, um, how can I help you?
[CUSTOMER][NEUTRAL] Oh, I need to verify the member's eligibility and the benefits status. So could you help me with that, please?
[AGENT][POSITIVE] Yes, I can help with eligibility and benefits. What's that policy number, please?
[CUSTOMER][NEUTRAL] Um, policy number I have today.
[CUSTOMER][NEUTRAL] 02145415, M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] Thank you. And if you could just give me uh their name and date of birth, please?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] It's [PII], [PII].
[AGENT][NEUTRAL] And I'm, I'm sorry, I do have to ask for a uh for a, uh, your phone number, please, just to verify.
[CUSTOMER][NEUTRAL] Uh, like I need to check out for the DMA benefits and the eligibility status.
[AGENT][POSITIVE] Yes, I can certainly do that. I just need a callback number please and the minute that we're disconnected.
[CUSTOMER][NEUTRAL] Oh, sure, sure, sure. Uh, [PII].
[AGENT][POSITIVE] Thank you so, so much. Um, the policy went into effect on [PII]. It is active.
[AGENT][NEUTRAL] Now this is a secondary or gap insurance.
[AGENT][NEUTRAL] And it has both in and out of hospital benefits. [PII], is there anything in particular that I can tell you about this gap in church? Would you like the outpatient benefits or is this for inpatient services?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Oh, I need for the medical, like the, I mean, the durable medical equipment.
[AGENT][NEUTRAL] Oh, yes, yes, of course, um.
[AGENT][NEUTRAL] Durable medical is not covered under this policy.
[AGENT][NEUTRAL] So DME.
[CUSTOMER][NEUTRAL] Oh, DM is not covered under this policy?
[AGENT][NEUTRAL] No, sir, it's not. I'm very sorry, it is not covered under this policy. Most, we do have policies that do, but this isn't one of them.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK, so there's no DMA benefits, right?
[AGENT][POSITIVE] That is right. You're absolutely right.
[CUSTOMER][NEUTRAL] OK. And could you check on that, are we in network under the member's plan or not?
[AGENT][NEUTRAL] Well, you just need to be in network with their major medical, um, David, we're, we're a secondary insurance and so we don't have a network, but you do, but as long as you're in network with their primary insurance, then you're good. It's just that, you know, in this case, you're, yes, sir.
[CUSTOMER][NEUTRAL] OK, if we are
[CUSTOMER][NEUTRAL] Oh, if we are contacted with the primary.
[CUSTOMER][NEUTRAL] We will consider the network, right?
[AGENT][POSITIVE] Yes, that's fine. That's great.
[CUSTOMER][NEUTRAL] OK, I got it. Just give me one moment.
[CUSTOMER][NEUTRAL] Can you spell your name for me, please?
[AGENT][NEUTRAL] Yes, it's [PII]
[AGENT][NEUTRAL] And the first letter of my last name is [PII], and [PII], we're gonna be using that in today's date as our reference.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you. Bye. Take care. Have a nice day.
[AGENT][POSITIVE] OK, well thank you for contacting ATO you have a good day.