AccountId: 011433970860
ContactId: 2b31a868-6322-4535-94b9-c29c25bc97c6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 162759 ms
Total Talk Time (AGENT): 94817 ms
Total Talk Time (CUSTOMER): 57616 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/27/2b31a868-6322-4535-94b9-c29c25bc97c6_20250227T20:31_UTC.wav
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[AGENT][POSITIVE] Thank you for contacting ATL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, good afternoon. My name is [PII]. Um, I'm calling from a provider facility because I need to verify benefits and eligibility for a member, please.
[AGENT][NEUTRAL] I can help with benefits and eligibility. What, um, and what is that policy number that we're looking at today?
[CUSTOMER][NEUTRAL] It's 125598.
[CUSTOMER][NEUTRAL] 3, M as in Mike, L as in Lima, and the number 8.
[AGENT][NEUTRAL] Thank you, and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Name is uh [PII]. Date of birth is [PII].
[AGENT][POSITIVE] I do appreciate that. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you. Now, whenever they have a, a policy renew renewal as a group, this is group secondary insurance. They always get a new policy number so that policy number is 02.
[CUSTOMER][NEUTRAL] Oh. Uh-huh.
[AGENT][NEUTRAL] 295788 and that went into effect on [PII].
[AGENT][NEUTRAL] Now, as I mentioned before, this is a secondary insurance. You can still use the other number. It's just that they have, you know, just connects to this one. This is a secondary insurance that picks up the deductible, co-payment or co-insurance or in and out of hospital settings, um, the ER, uh, that sort of thing. Um, is there anything in particular that I can tell you about the policy, or?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Um, just to see if the number has any, um, outpatient benefits. I'm, I'm assuming he still does because the year just started, but you never know.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Oh, of course. Uh, so for outpatient benefits, we, we will pick up the deductible, co-payment or co-insurance up to $3500. It's just a verification of benefits, not a guarantee of payment. As of the current, uh, time though, I forgot to tell you, it looks like he has used his benefits. So let me just check and be absolutely certain.
[CUSTOMER][NEUTRAL] Oh,
[AGENT][NEUTRAL] Um,
[AGENT][NEGATIVE] OK, yes, he did. He used up, uh, all of $3500 so he does not have any benefits available for the calendar year [PII]. That's they've all been used.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK. Well,
[CUSTOMER][POSITIVE] Yeah, that teaches me to assume. Um, all right, thank you so much. Um, do you provide reference numbers for your call?
[AGENT][NEUTRAL] Yes, my name is [PII]. The first letter of my last name is [PII], and we're gonna use that today's date as a reference. Is, is there anything else at all I can help with?
[CUSTOMER][POSITIVE] That would be all. Thank you so much.
[AGENT][POSITIVE] OK, thanks for contacting UT