AccountId: 011433970860
ContactId: 328b9c01-2e1b-467c-af0f-722b8f036bf3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 205820 ms
Total Talk Time (AGENT): 95357 ms
Total Talk Time (CUSTOMER): 75028 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/328b9c01-2e1b-467c-af0f-722b8f036bf3_20250528T18:53_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, this is [PII], and I am calling from Botox one in a recorded line. I am calling at the request of the provider to see uh the maximum reimbursable amount for this patient's plan.
[AGENT][POSITIVE] Yes, I can certainly help with benefits. [PII], what's that policy number, please?
[CUSTOMER][NEUTRAL] It is 02267455.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] It's [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] It is [PII], option one.
[AGENT][NEUTRAL] Thank you. The policy went into effect on [PII]. It is active. Now, the policy has a maximum benefit for outpatient services or inpatient services up to $6000 per calendar year. That's just a verification of benefits, not a guarantee of payment.
[AGENT][NEUTRAL] And it looks like [PII] has, uh, it's possible that she may have
[AGENT][NEUTRAL] Let me see how much she's used. It looks like she has used $6000 of those benefits so far. Let me just check here.
[CUSTOMER][NEUTRAL] Oh OK.
[AGENT][NEUTRAL] She may have used all her benefits, so let me just check. She's in just a minute.
[AGENT][NEUTRAL] OK, so [PII] has used all of the benefits for the calendar year [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] If she had $6000 the benefits against the verification, not a guarantee payment, but she's used all of them.
[CUSTOMER][NEUTRAL] OK, got it. And is this only individual or there is uh like family reimbursement?
[AGENT][NEUTRAL] It's $6000 per individual. It's, it's only [PII] who's used all.
[CUSTOMER][NEUTRAL] OK. So there is no other uh member on that plan, right?
[AGENT][NEUTRAL] Yes, this is a family plan and uh the remaining members of the family that uh they still have benefits that [PII] does not.
[CUSTOMER][NEUTRAL] Sir, it got cut the, the last part, uh, I understood that it is a family, but what else?
[AGENT][NEUTRAL] OK, the, um, the fam uh, [PII] is the only member of the family who has used all of her benefits, outpatient benefits for the calendar year [PII].
[CUSTOMER][NEUTRAL] Oh, OK, got it. So just to be sure there is no family that [PII] can use because he already used the individual, right?
[AGENT][POSITIVE] That's correct, yes, that's correct.
[CUSTOMER][POSITIVE] OK, got it. Thank you very much. Yeah, that will be all. And to reference my, can I have the initial of your last name and the reference number?
[AGENT][NEUTRAL] Yes, um, we're gonna use my name which is [PII]. The first letter of my last name is [PII].
[AGENT][POSITIVE] And we'll use that in today's date as a reference and if there's nothing else I can help with, [PII], then thank you for contacting ATL.
[AGENT][POSITIVE] I hope you have a very good day. Thank you for calling us.
[CUSTOMER][POSITIVE] Thank you.