AccountId: 011433970860
ContactId: 1b67b481-2038-4d4c-860b-f26120ceb3f0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 178589 ms
Total Talk Time (AGENT): 75898 ms
Total Talk Time (CUSTOMER): 52911 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/1b67b481-2038-4d4c-860b-f26120ceb3f0_20250327T19:12_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from Wellstar MCG Health. I need to verify benefits on a patient. Are you able to assist me with that?
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Absolutely. I'm happy to verify benefits. Can I get the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, I have D as in Delta 43732855.
[AGENT][NEUTRAL] OK. Unfortunately, I can't pull the member with that number. Do you have their name or social?
[CUSTOMER][NEUTRAL] What about a 0? I do have with policy and certification is that the number you need?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yeah, that's
[CUSTOMER][NEUTRAL] I'm sorry, it's [PII].
[AGENT][NEUTRAL] All right, let me try that. That sounds more.
[AGENT][NEUTRAL] Correct. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It'll be for [PII]. Date of birth is [PII].
[AGENT][POSITIVE] All right, thank you so much. So the patient is active. The effective date on the plan is [PII].
[CUSTOMER][NEUTRAL] OK. Do you, um, do you have coverage? He's, he came for an outpatient visit for a well check like the immunizations. Does he have coverage for that?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see with the outpatient.
[AGENT][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Give me 1 2nd. I need to pull the policy here.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah, but what time?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] To
[CUSTOMER][NEUTRAL] And one.
[CUSTOMER][NEUTRAL] So I don't know
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] OK, so it looks like the member's plan does allow um outpatient, it looks like as far as an office visit, um, they are allowed up to $5 a year and the benefit payment is $75 per visit. So that's what the insurance is going to pay towards the visit.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let me see if I see anything under exclusions in regards to immunizations or shots or anything. One second.
[AGENT][NEUTRAL] I don't show anything under the exclusions, so, um, I don't believe that that would be anything excluded from the office visit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, all right, that's what I need to know thank you [PII].
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][POSITIVE] OK you too bye bye.