AccountId: 011433970860
ContactId: 1efa2faa-1b8a-449f-a775-b00d73ca7786
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 196460 ms
Total Talk Time (AGENT): 85019 ms
Total Talk Time (CUSTOMER): 99739 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/21/1efa2faa-1b8a-449f-a775-b00d73ca7786_20250521T13:03_UTC.wav
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[AGENT][POSITIVE] And thank you for calling APL. This is easy. How can I help you?
[CUSTOMER][POSITIVE] Yes, um, I'm so sorry I didn't catch your first name.
[AGENT][NEUTRAL] Um, it's [PII], um, it's spelled [PII] Last initial is [PII].
[CUSTOMER][NEUTRAL] My name is [PII] and I have the same uh initial list of your last name. So I'm calling from a provider's office and I'm just calling for eligibility and benefits, please.
[AGENT][POSITIVE] Oh, sure, [PII]. I can assist you with benefits. Um first, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. Thank you. Now, could I get the policy number, please?
[CUSTOMER][NEUTRAL] Yes, give me just one second please. I'm just bringing this back up. OK, it is.
[CUSTOMER][NEUTRAL] Uh, wait a second, this is not the person, is it? Hold on. I can't find this person now. Oh boy, I just had it up. One second, please. I'm so sorry.
[AGENT][POSITIVE] Well, no problem.
[CUSTOMER][NEUTRAL] where are you? Where are you? OK, here you go, uh, 01702711. I'm sorry for the hold with that.
[AGENT][NEUTRAL] Oh, no problem. Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] OK, thank you and just let me.
[CUSTOMER][NEUTRAL] I had a representative who wrote notes, but I don't know this is all the way back in January and it was saying that this is considered the secondary insurance and that it covers copay, deductible and co-insurance up to $4000 per calendar year and 0 has been used. I don't know if it's still the same, but that's the reason why I was calling.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK. Yes, ma'am. And just let me advise you that verification of coverage does not guarantee payment of claims. Um, I'm showing the effective date on this policy was [PII] and the policy is still active. And yes, this is for secondary gap insurance. What we do is cover the co-pay, the co-insurance, and the deductible for coverage services. Um, what type of service is this for or where will it take place?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] Actor.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Uh, the specialist office.
[AGENT][NEUTRAL] OK, for services provided in office. Yes, ma'am. We do cover up to 4000 per calendar year for the co-insurance and the deductible, but the co-pay for the office visit is not covered. And let's see.
[CUSTOMER][NEUTRAL] It's a new office but specialist.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] I got up it.
[AGENT][NEUTRAL] And for this year's.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So far she's used $99.83 of the $4000.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Wonderful. OK, one last thing if you don't mind, if I could just get a reference number.
[CUSTOMER][POSITIVE] But it's cool.
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date.
[CUSTOMER][POSITIVE] Wonderful thank you so much you have a wonderful day.
[AGENT][POSITIVE] OK, thank you, [PII], for calling ATL. Is there anything else I can assist you with?
[CUSTOMER][POSITIVE] That will be all for today. Thank you. Have a great day.
[AGENT][NEUTRAL] You do the same. Thank you for calling ATF mhm bye.
[CUSTOMER][NEUTRAL] Bye bye.