AccountId: 011433970860
ContactId: 1a6cce84-70ff-42e5-bd57-d8870a151224
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 168059 ms
Total Talk Time (AGENT): 95550 ms
Total Talk Time (CUSTOMER): 52179 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/1a6cce84-70ff-42e5-bd57-d8870a151224_20250609T12:37_UTC.wav
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[AGENT][NEUTRAL] For contacting ATL, my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. I'm calling to verify benefits and eligibility for a patient please.
[AGENT][NEUTRAL] I can have the benefits and eligibility, but who am I speaking please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], thank you. What's that policy number we're looking at today?
[CUSTOMER][NEUTRAL] It is 02336008 M as in Mary, L as in Larry, and the number 8.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Last name [PII]. That's [PII] Date of birth [PII].
[AGENT][POSITIVE] I appreciate that. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] Are you?
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Um, [PII], is there a callback number I can have? Yeah.
[CUSTOMER][NEUTRAL] Hold on 1 2nd.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. The policy went into effect on [PII]. It is active. You mentioned wanting to know about the benefits. Um, this policy has both in and out of hospital benefits as well as office visits, uh, treatments or procedures. This is a secondary or gap insurance and for outpatient hospital services, we will pick up the deductible, co-payment or co-insurance for outpatient hospital settings up to $6600.
[AGENT][NEUTRAL] For inpatient services of 18 hours or more, we pick up the deductible, co-payment or co-insurance from the major medical up to $6600. This is just a verification of those benefits, not a guarantee of payment.
[AGENT][NEUTRAL] And for the calendar year [PII], it looks like uh none of the benefits have been used yet. Now is there anything else I can tell you about the secondary or gap insurance?
[CUSTOMER][NEUTRAL] Um, do you cover anything from the primary and the office visit?
[AGENT][NEUTRAL] Now, the, what we do is we cover the treatments um within the physician's office, the treatments or procedures within the physician's office. As far as the office visit co-pay itself, um, that is not covered.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] OK, that's I just wanted to be clear on that.
[AGENT][NEUTRAL] Is there anything else you want?
[AGENT][NEUTRAL] Sure. Is there anything
[CUSTOMER][NEUTRAL] Um, no, if I could just get a reference number for the call, please.
[AGENT][NEUTRAL] Yes, my name is [PII]. The first letter of my last name is [PII]. We're gonna use that today's date is our record.
[CUSTOMER][POSITIVE] Perfect all right thank you so much for your help.
[AGENT][POSITIVE] Thanks for contacting