AccountId: 011433970860
ContactId: 1addcf48-b038-4a3d-bd80-7f5caf6eb8bc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 245399 ms
Total Talk Time (AGENT): 92334 ms
Total Talk Time (CUSTOMER): 106967 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/1addcf48-b038-4a3d-bd80-7f5caf6eb8bc_20250130T21:31_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], good afternoon. My name is [PII]. The initial of my last name is [PII], and I'm calling from the provider's office is [PII], and a good call back number is [PII].
[AGENT][POSITIVE] OK, thank you so much, [PII] for giving me that information.
[CUSTOMER][NEUTRAL] Of course.
[AGENT][POSITIVE] How can I help you today?
[CUSTOMER][NEUTRAL] Yes, so I was just, um, giving you guys a call because it's for mutual patient and I just wanted to verify from the, um, supplementary insurance or the gap insurance if it covers from his primary that he has for the AMed as far as deductibles or copay.
[AGENT][NEUTRAL] OK, I can call, I can verify benefits for you, Miss [PII]. Can you please give me the name of the patient?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, it's gonna be, let me, um, it's gonna be for [PII] and his last name is [PII]
[AGENT][NEUTRAL] OK, and what's [PII]'s date of birth?
[CUSTOMER][POSITIVE] Uh, yes, let me get that for you right now.
[CUSTOMER][NEUTRAL] I have is [PII].
[AGENT][NEUTRAL] Thank you. And what's [PII]'s policy number?
[CUSTOMER][NEUTRAL] Uh yes, I have here 021-91098 M as in Mary, L as in lollipop 8.
[AGENT][NEUTRAL] OK, let me pull in that policy real quick.
[CUSTOMER][POSITIVE] Alrighty.
[AGENT][NEUTRAL] OK, I do show that [PII] does have an active policy. His effective date is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this is just to verify his coverage it's not a guarantee of payment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] This is a supplemental insurance policy that.
[AGENT][NEUTRAL] Is billed secondary to his primary.
[AGENT][NEUTRAL] It is a gap gap insurance that does help with deductible, co-pay, and co-insurance.
[AGENT][NEUTRAL] He has an inpatient benefit amount per calendar year of $6000 and then he has an outpatient per calendar day benefit of $750.
[CUSTOMER][NEUTRAL] Oh OK, so let me just put that here.
[CUSTOMER][NEUTRAL] So the 750 is for the outpatient, correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And then the 6000 was for the inpatient, OK.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Alrighty, and has he met any of those or anything accumulated? Yeah.
[AGENT][NEUTRAL] Let me look.
[AGENT][NEUTRAL] Let me, let me look real quick.
[AGENT][NEUTRAL] Nothing has been met for the year of [PII].
[CUSTOMER][NEUTRAL] OK, sounds good. And so then just to make sure so you guys do cover from like any copays or deductibles from the primary, correct?
[AGENT][POSITIVE] Yes, that's what the insurance helps with the deductible, co-pay and co-insurance.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK perfect and so you um your name is [PII] correct with a [PII] or [PII]?
[AGENT][POSITIVE] Yes ma'am [PII] a [PII]
[CUSTOMER][NEUTRAL] And the initial of your last name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Oh OK, and the call reference number is in your name in today's date?
[AGENT][NEUTRAL] Yes, it is.
[CUSTOMER][NEUTRAL] Alrighty, and you said the effective date of the APL um was [PII] of this year or last year?
[AGENT][NEUTRAL] Let me check back there again. I'll give you it is [PII].
[CUSTOMER][NEGATIVE] Oh sorry.
[CUSTOMER][POSITIVE] [PII]. OK, perfect, thank you so much for all your help.
[AGENT][POSITIVE] You're very welcome you have a great day and thanks for calling APL.
[CUSTOMER][POSITIVE] Alrighty you too thank you bye.
[AGENT][NEUTRAL] Bye bye.