AccountId: 011433970860
ContactId: 30ff16a4-0cdf-4dcc-8b30-34de8b514f5b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 316970 ms
Total Talk Time (AGENT): 127746 ms
Total Talk Time (CUSTOMER): 90835 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/30ff16a4-0cdf-4dcc-8b30-34de8b514f5b_20250306T15:12_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] 8
[CUSTOMER][NEUTRAL] Uh, yes, I'm just calling to verify eligibility and benefits for a patient.
[AGENT][NEUTRAL] OK, I can help you with eligibility and benefits. May I please get your name, your callback number, the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Yes, my name is [PII].
[CUSTOMER][NEUTRAL] My number is [PII] and I'm calling from Palm Primary Care or Strategic Medical Group, whichever way it's listed.
[AGENT][NEUTRAL] OK, thank you very much. And then what is the patient's name, the birth and policy number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Name is [PII]. I'm not really sure if I'm pronouncing that right. Um, date of birth is [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And policy number is 02565474.
[AGENT][NEUTRAL] Let me look that up real quick.
[AGENT][POSITIVE] OK, I do show that [PII] does have an active policy and her effective date.
[AGENT][NEUTRAL] Put in
[CUSTOMER][NEUTRAL] What.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] I can let the computer get it.
[AGENT][NEUTRAL] Her effective date is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And this is just to verify her benefits. It's not a guarantee of payment. She has a hospital indemnity plan. It's a limited plan, um.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] She happens to go into the hospital.
[AGENT][NEUTRAL] And the benefits are pulling up now for me. She has um a hospital benefit one day per calendar year of $1000.
[AGENT][NEUTRAL] And then if she's confined um to the hospital, she has a 30 day benefit that pays $100 per day. Uh she also has uh.
[AGENT][NEUTRAL] Physician office visits, she gets $4 a year for outpatient accident or sickness treatment that pays $100.
[CUSTOMER][NEUTRAL] OK, so 4 office visits and you guys will pay up to $100 for each of those office visits?
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] For accident or sickness.
[CUSTOMER][NEUTRAL] OK, what about um like well care preventative care?
[CUSTOMER][NEUTRAL] When
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] I only see preventive care in the event of preventative elective surgery.
[CUSTOMER][NEUTRAL] OK, so regular PCP preventative care would not be covered. She would be responsible 100%.
[AGENT][NEUTRAL] Right, I do not see that under her plan.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, if, um,
[AGENT][NEUTRAL] It's done in a physician's office or an urgent care center.
[CUSTOMER][NEUTRAL] Uh huh
[AGENT][NEUTRAL] Um, then the policy does pay $100 flat rate, um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] Alright, and can I get a um reference number please?
[AGENT][NEUTRAL] Yes ma'am, you can use my name. It's [PII] and today's date.
[CUSTOMER][NEUTRAL] And is that [PII]?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] All right, thank you so much.
[AGENT][POSITIVE] You're very welcome.
[CUSTOMER][POSITIVE] You have a great weekend.
[AGENT][POSITIVE] You're very welcome. Hope you have a you too, Miss [PII]. Thank you so much and thanks for calling APL.
[CUSTOMER][POSITIVE] Thank you. Uh huh.
[AGENT][NEUTRAL] Mhm. Bye-bye.
[CUSTOMER][NEUTRAL] Yes ma'am bye bye.