AccountId: 011433970860
ContactId: 227dd227-b9d7-4004-a71b-56a016ff0a23
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 191779 ms
Total Talk Time (AGENT): 103044 ms
Total Talk Time (CUSTOMER): 68933 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/25/227dd227-b9d7-4004-a71b-56a016ff0a23_20250225T19:45_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling ATL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling from the Atlanta Allergy and asthma clinic and I need to verify benefits for one of your members, please.
[AGENT][POSITIVE] Well, it would be a pleasure to assist you with the um benefit, [PII]. What is the patient's policy number, please?
[CUSTOMER][NEUTRAL] It is 02596142.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Thank you, [PII]. And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] I might have mistyped that. Did you say 2596412?
[CUSTOMER][NEUTRAL] 02596142
[AGENT][NEUTRAL] 142. I do apologize.
[AGENT][POSITIVE] That it helps when I type in the right numbers. Thank you for your patience.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] [PII], what is a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII] option 0.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And 6822. I can help you with eligibility and benefits for [PII]. His policy is active.
[AGENT][NEUTRAL] Effective date is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you said you were needing benefits as well?
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] I can help you with that. What type of coverage are you needing, [PII]?
[CUSTOMER][NEUTRAL] We are a specialist and so I was trying to see if they have coverage for a specialty office visit, um, as well as allergy testing and treatment, and I do have colds if you need them.
[AGENT][NEUTRAL] OK, and I can help you with that. So, this is a limited indemnity policy. There's no deductible copay or co-insurance. We pay $75 per office visit, that does include the visit or any.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Services
[AGENT][NEUTRAL] During that visit.
[AGENT][NEUTRAL] Pay $75 and that benefit is available 5 times per calendar year and [PII] has not used any of those visits.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] As of yet,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, that is the verification of coverage, not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK. Do you
[CUSTOMER][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So does it only cover the office visit or does it cover like allergy testing, allergy injections, and allergy serum?
[AGENT][NEGATIVE] That would not be covered under this plan.
[CUSTOMER][NEUTRAL] No, OK, got it, got it, got it, got it. OK, that's all that I needed to know. May I have a reference number please?
[AGENT][NEUTRAL] It would be my name and today's date, and I spell my name [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] And [PII], it was a pleasure to assist you with those benefits. Anything else I can help you with today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No thank you, [PII] you have a wonderful day.
[AGENT][POSITIVE] I hope you have a wonderful day as well. Thank you for calling APL [PII]. Take care.
[CUSTOMER][POSITIVE] You too, my pleasure bye bye.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] She's