AccountId: 011433970860
ContactId: 2205fe9e-1b43-40f2-9da0-d04af87a96f6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 308079 ms
Total Talk Time (AGENT): 157750 ms
Total Talk Time (CUSTOMER): 100133 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/30/2205fe9e-1b43-40f2-9da0-d04af87a96f6_20250430T16:10_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling ATL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Good morning. So, uh, my name is [PII]. I'm calling from provider office, uh, Phillips. Uh, phone call may be monitored or recorded for quality and training purposes. So I'm trying to obtain patient, uh, eligibility and benefits, please.
[AGENT][POSITIVE] OK, sure. I can assist you with eligibility and benefits. Can you spell your name for me?
[CUSTOMER][NEUTRAL] Sure. [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you, and Miss [PII], may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure. [PII].
[AGENT][NEUTRAL] Thank you and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Sure. I do have 02597080.
[AGENT][NEUTRAL] I'm sorry, I got 02590.
[CUSTOMER][NEUTRAL] 02597080.
[AGENT][NEUTRAL] 080.
[AGENT][NEUTRAL] Mm didn't pull anything up. Let me have that one more time.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, maybe that's all I have so I don't know, uh 02597080?
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK. What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Sure. I have [PII] [PII].
[AGENT][POSITIVE] OK, perfect, thank you. And what type of service is being rendered for benefits?
[CUSTOMER][NEUTRAL] It's an outpatient diagnostic testing.
[AGENT][NEUTRAL] OK. All right, um, what type of test is it?
[CUSTOMER][NEUTRAL] It's a heart monitor, so we charge for the reading of the monitor.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Reading, just for the reading of the monitor?
[CUSTOMER][POSITIVE] Correct. Correct.
[AGENT][NEUTRAL] OK. All right.
[AGENT][NEUTRAL] OK, before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage. And this particular policy is one of our limited hospital indemnity plans. Um, we have an effective date of [PII] and it is active. Um, and let me go ahead and give you benefits for. Is it gonna be like, um, just like a regular office?
[CUSTOMER][NEUTRAL] We bill under office setting, so yeah, but uh outpatient we are independent lab, yeah.
[AGENT][NEUTRAL] Of setting.
[AGENT][NEUTRAL] So you're an independent lab?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK. So when you bill, do you know if you bill as an office or an independent lab?
[CUSTOMER][NEUTRAL] That's the office, I believe, right? Office I think the bill.
[AGENT][NEUTRAL] Office, OK, OK, alright.
[AGENT][NEUTRAL] OK, bear with me just a second.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so it looks like we cover $75 per visit, maximum of 6 visits per covered person per calendar year.
[CUSTOMER][NEUTRAL] OK. It's a limited plan. Is there any specific network that you use for a member or?
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] If if the provider participates with multi-plan, they get that additional discount but it is not required, yeah, one with a discount.
[CUSTOMER][NEUTRAL] Yeah. Yes.
[CUSTOMER][NEUTRAL] Discount.
[CUSTOMER][NEUTRAL] OK. OK. We are part of a multi-plan. OK. OK. Is this patient primary insurance?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, this is, um, we're not sure if he has any other policies out there, but this is just a limited policy. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK. And what is your PO box number for the claims, please?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Sure, uh, for this, let me make sure I give you the correct 11 moment. OK, so this one does come to us. So that's [PII].
[AGENT][NEUTRAL] 950.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] They have a payer ID, electronic payer.
[AGENT][NEUTRAL] The electronic payer ID is 60801.
[CUSTOMER][NEUTRAL] 60801. OK. And I'm sorry, what was your name? I didn't catch your name. You said [PII]?
[AGENT][NEUTRAL] Mhm. Yes.
[AGENT][NEUTRAL] So, [PII].
[CUSTOMER][NEUTRAL] [PII]. OK, any reference number for the call, or?
[AGENT][NEUTRAL] We don't have reference numbers you can use my name in today's date.
[CUSTOMER][POSITIVE] OK, just your name. All right. Thank you very much. I appreciate your help. Have a good day. Take care.
[AGENT][NEUTRAL] Mhm. Yes.
[AGENT][POSITIVE] You're welcome. You as well, and thank you for calling APL. Bye-bye. Bye.
[CUSTOMER][NEUTRAL] Bye. Bye bye.
[CUSTOMER][NEUTRAL] Bye.