AccountId: 011433970860
ContactId: 2f353007-9ee8-498b-8b9a-1530939d1f31
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 191070 ms
Total Talk Time (AGENT): 92654 ms
Total Talk Time (CUSTOMER): 62762 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/16/2f353007-9ee8-498b-8b9a-1530939d1f31_20250616T14:39_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, my name is [PII]. I'm calling from an allergist office in regards to a patient that's here in the office. I wanted to see um if we were um in network with this insurance.
[AGENT][POSITIVE] I'm sure, [PII] I can assist you with benefits. Um, first, I'll need a good callback number just in case we're disconnected.
[CUSTOMER][NEUTRAL] My phone number is [PII].
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] It is 02607.
[CUSTOMER][NEUTRAL] 117.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you and just submit advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII]. The policy is still active, and you said this is for services provided in the office?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK. And for this policy, this is for secondary gap insurance. What we do is cover the co-insurance and the deductible for services provided in office. And let's see, we cover up to $500 per day.
[AGENT][NEUTRAL] Um, the co-pay for the office visit is not covered, but again, we cover the co-insurance and the deductible after the primary insurance processes the claim, and there is no network, um, because we go by the primary insurance guidelines.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] And [PII], is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] I apologize, what was that?
[AGENT][NEUTRAL] Um, is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] Are you able to tell me if um my provider, the provider I work for um is in network or does it matter?
[AGENT][NEUTRAL] Um, right, there is no network under our insurance because we go by the primary insurance guidelines. Yes, ma'am.
[CUSTOMER][NEGATIVE] No network.
[CUSTOMER][NEUTRAL] OK, got you, and then, um, so any like so any CPT code would work and they would just use the primary insurances guidelines for whatever it is?
[AGENT][POSITIVE] Yes, ma'am, that's correct.
[CUSTOMER][NEUTRAL] OK, perfect. I am I able to get a reference number for this call?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. My name is [PII], um it's spelled [PII] Last initial is [PII] and today's date.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] Thank you so much for your help and your time I appreciate it.
[AGENT][POSITIVE] OK. Thank you, [PII], for calling ATL. You have a great day. Mm bye.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Mm thank you.