AccountId: 011433970860
ContactId: 20cd69b2-7b19-4d8b-a2a7-6151b413b603
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 147240 ms
Total Talk Time (AGENT): 73720 ms
Total Talk Time (CUSTOMER): 78520 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/20cd69b2-7b19-4d8b-a2a7-6151b413b603_20250218T14:20_UTC.wav
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[CUSTOMER][NEUTRAL] People
[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII]. I'm calling from provider's office. I need to verify, um, eligibility for, uh, a patient that's coming into the office this morning.
[AGENT][NEUTRAL] Um, yes, ma'am. I can assist you with eligibility. Um, first, could I get your name and a callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Uh-huh
[CUSTOMER][NEUTRAL] Yes, it's [PII] and callback number is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now, could I get the policy number, please?
[CUSTOMER][NEUTRAL] Policy number I have here is 02221656 M as in mom L as in Larry 8.
[AGENT][NEUTRAL] Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Date of birth is [PII] and the child's name is [PII]. um I'm gonna spell the last name is [PII]
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you 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. Um, is this for inpatient or outpatient or an office visit?
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] It's the opposite.
[AGENT][NEUTRAL] OK, for services provided in office, we cover up to 3500 per calendar year and that's for the co-insurance and the deductible after the primary insurance processes the claim, but the co-pay for the office visit is not covered.
[CUSTOMER][NEUTRAL] To
[CUSTOMER][NEUTRAL] OK, so it doesn't cover co please. OK, perfect. OK, for office if it's OK, it does not cover. OK, perfect.
[AGENT][NEUTRAL] Right, for office visits.
[CUSTOMER][NEUTRAL] May it's like a gap insurance, right, correct?
[AGENT][NEUTRAL] Yes, ma'am, it is. Mhm.
[CUSTOMER][NEUTRAL] OK, may I have a reference number for the verification?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. My name is [PII] and it's spelled [PII] My last initial is [PII] and today's date. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] No thank you so much for your help I appreciate it have a nice day take care bye bye.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL. Mhm. Bye.