AccountId: 011433970860
ContactId: 1d25b856-3799-4d9f-8d1b-27007ce72838
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 171300 ms
Total Talk Time (AGENT): 83559 ms
Total Talk Time (CUSTOMER): 69319 ms
Interruptions: 2
Overall Sentiment: AGENT=1.1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/18/1d25b856-3799-4d9f-8d1b-27007ce72838_20250618T18:35_UTC.wav
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[AGENT][NEUTRAL] Contacting ATO, my name is.
[CUSTOMER][NEUTRAL] Hi, I'm calling to uh obtain a verification of benefits for patients.
[AGENT][NEUTRAL] I can help with benefit and with whom am I speaking, please?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] [PII], thank you. What is the policy number we're looking at today?
[CUSTOMER][NEUTRAL] It's 020984.
[CUSTOMER][NEUTRAL] 5 M as in Mary, L as in Larry 8.
[AGENT][NEUTRAL] OK. Um, 0, excuse me, I'm sorry, 0209845. Is that what you said, [PII]?
[CUSTOMER][NEUTRAL] No, 0202.
[CUSTOMER][NEUTRAL] 984 5.
[AGENT][NEUTRAL] OK, thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII] [PII]
[AGENT][NEUTRAL] Thank you. I need a callback number please in the event that we're disconnected.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. The policy went into effect on [PII]. It is active. This is a, um, secondary or gap insurance that has both in and out of hospital benefits as well as treatment within the physician's office. Is there anything in particular that I could tell you about the policy? You mentioned benefits, is there inpatient or outpatient?
[CUSTOMER][NEUTRAL] It is the, is the patient covered um
[CUSTOMER][NEUTRAL] Is this a short term or limited plan?
[AGENT][NEUTRAL] No, this is a secondary or gap insurance, and what we're meant to do is pick up the deductible, co-payment or co-insurance from your major medical.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK perfect and how much is the annual um limit for the patient?
[AGENT][NEUTRAL] For outpatient services, it's $500 per calendar day. For inpatient hospital stays, it's $1000 per calendar year. That is a verification benefit it's not a guarantee of pay.
[CUSTOMER][NEUTRAL] OK, so 500 per day.
[CUSTOMER][NEUTRAL] And the patient is covered for outpatient services correct? in a hospital setting outpatient hospital? OK, perfect. Does the patient have a deductible or out of pocket?
[AGENT][POSITIVE] That is correct. That is correct.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Is there anything else I can help with? Oh.
[AGENT][NEUTRAL] Oh, no, no. This is just, uh, it's just the benefits. There's no deductible on this policy.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][POSITIVE] OK perfect thank you so much. Can I have a reference number for this call?
[AGENT][NEUTRAL] Yes, my name is [PII]. The first letter of my last name is [PII]. We'll use that today's date.
[CUSTOMER][NEUTRAL] [PII]?
[AGENT][NEUTRAL] [PII], yes, [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And today's date.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] OK, perfect. Thank you so much, [PII].
[AGENT][POSITIVE] Thank you for contacting AT.