AccountId: 011433970860
ContactId: 3145e317-8f72-4e62-9bf4-b8bedbba3735
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 179679 ms
Total Talk Time (AGENT): 84141 ms
Total Talk Time (CUSTOMER): 56136 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/3145e317-8f72-4e62-9bf4-b8bedbba3735_20250131T16:39_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, hi, good morning, [PII]. I'm calling to verify if the member's active with the insurance.
[AGENT][NEUTRAL] OK, I can help you with eligibility. Can I please get your name and your callback number?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, thank you, [PII]. What is the patient's name?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then what's [PII]'s date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And his policy number, please?
[CUSTOMER][NEUTRAL] I have 014.
[CUSTOMER][NEUTRAL] 80064 the letters ML 7.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK. I do show that Dwight does have an active policy. His effective date is
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the policy is still active.
[CUSTOMER][NEUTRAL] OK perfect. Is this like a Medicare supplement plan or what?
[AGENT][NEUTRAL] It, um, and this is just to verify its coverage. It's not a guarantee of payment. It's a um secondary insurance that's billed after the primary. It's a gap insurance that helps with deductible, co-pay and co-insurance.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, gap.
[CUSTOMER][NEUTRAL] OK and then what would be the claims address please?
[AGENT][NEUTRAL] The claims address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that's in [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][POSITIVE] Awesome and then would authorization be required?
[AGENT][NEUTRAL] No, ma'am, because it's not the major medical.
[CUSTOMER][POSITIVE] Got you. So all not required.
[CUSTOMER][NEUTRAL] OK, and your last name initial please.
[AGENT][NEUTRAL] It's A
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And then reference number for the call.
[AGENT][NEUTRAL] You can use my name and today's date.
[CUSTOMER][NEUTRAL] And then does this have um inpatient hospital benefits?
[AGENT][NEUTRAL] Yes ma'am, let me tell you what the benefit is for inpatient.
[CUSTOMER][POSITIVE] It does OK.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] He has $6600 per calendar year up with his inpatient deductible co-pay or co-insurance.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Perfect thank you so much for your time, [PII].
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. You have a great weekend and thanks for calling APL. Bye-bye, ma'am.
[CUSTOMER][NEUTRAL] You too.
[CUSTOMER][POSITIVE] Thank you bye bye.