AccountId: 011433970860
ContactId: 29a08d0b-d569-412f-bbd8-5180abb7cfab
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 202279 ms
Total Talk Time (AGENT): 119259 ms
Total Talk Time (CUSTOMER): 57111 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/03/29a08d0b-d569-412f-bbd8-5180abb7cfab_20250603T17:31_UTC.wav
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[AGENT][POSITIVE] Thank you for contacting ATL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling regarding a patient that we have in the office. Um, I just wanted to know, um, regarding the benefits if you guys pick up a copay or any deductible like that.
[AGENT][NEUTRAL] OK, yes, I can certainly help with that. And um well, what is uh the uh policy number that we're looking at today?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So, I'm a little, I'm a little confused. Oh, I think it's this 1. 02502445 ML 7.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the first name and date of birth?
[CUSTOMER][NEUTRAL] Uh first name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] I appreciate that. Well I'm looking that up, if I could just have a callback number please in the event that we're disconnected.
[CUSTOMER][NEUTRAL] [PII] is the direct line.
[AGENT][NEUTRAL] Thank you. The policy went into effect on [PII]. It is active. Now, the secondary or gap insurance does pick up the deductible, co-payment, or co-insurance for in and out of hospital settings, um, as well as treatment within the physician's office and the office visit co-pay. So is there anything in particular that we're looking at that I can help with?
[CUSTOMER][NEUTRAL] Um, so that's what I I wanted to know. So he's, he's in, in a specialist office. Would that be considered in hospital or outpatient?
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] That's gonna be the outpatient and what we will do is we'll pick up the uh office visit co-pay, uh, up to $25 for a regular physician or $50 for a specialist. That is just a verification of the benefits, not a guarantee of payment, and they have 4 of those visits throughout the calendar year. um, that has not been used yet. Uh, also we will pick up the deductible, co-payment or co-insurance for treatment or procedures within the physician's office up to $2500 and again.
[AGENT][NEUTRAL] And that is just a verification of benefits, not a guarantee of payment, and none of those benefits have been used. So the office visit copay and the uh and treatment or or uh procedures within the physician's office are all gonna be covered.
[CUSTOMER][NEUTRAL] Oh, OK, so you pick up the entire thing, not just up to $50?
[AGENT][NEUTRAL] Uh, well, for the office visit copay, we will pick up to up to $50 for for a specialist office visit.
[AGENT][NEUTRAL] And again, that's just the verification, not a guarantee of payment, but, but the uh treatment or or procedures within the physician's office is picked up at $2500.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Again, just the verification that it doesn't look like Eddie's used any of the benefits at all.
[CUSTOMER][NEUTRAL] Go
[CUSTOMER][NEUTRAL] Got it and I just need a reference number for this call, and you said your name was [PII], correct?
[AGENT][NEUTRAL] Uh, my name is [PII]. We're gonna use that today's date as our reference.
[AGENT][NEUTRAL] Is there anything else at all that I may help you with?
[CUSTOMER][NEUTRAL] I'm sorry I couldn't hear you. What is the reference number?
[AGENT][NEUTRAL] Uh, my name is [PII], and the first letter of my last name is K as in kite. We're gonna use that as today's date as our reference.
[CUSTOMER][POSITIVE] OK, and no, that'll be all thank you so much.
[AGENT][POSITIVE] OK, thanks for contacting APR we can.