AccountId: 011433970860
ContactId: 339a2241-ae91-4658-adac-b956dfc2cbdf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 143699 ms
Total Talk Time (AGENT): 77231 ms
Total Talk Time (CUSTOMER): 49498 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/339a2241-ae91-4658-adac-b956dfc2cbdf_20250121T13:56_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, I'm calling to verify uh coverage and details of plan for a patient of ours.
[AGENT][NEUTRAL] Um, yes, ma'am. I can assist you with benefits. Um, first, could I get your name and a good callback number?
[CUSTOMER][NEUTRAL] Yes, my name is [PII].
[CUSTOMER][NEUTRAL] Callback number [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII]. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] I have 980010304.
[AGENT][NEUTRAL] OK, that's not one of our policy numbers. Um, on the card, do you see where it says outpatient certificate number or outpatient benefits?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah, I apologize. I had the wrong one. I have 022.
[CUSTOMER][NEUTRAL] 92.
[CUSTOMER][NEUTRAL] 668.
[AGENT][NEUTRAL] OK, thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] It's [PII] By [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII] and just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII] and the policy is still active. Um, is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Office. Uh, we're allergy, asthma and immunology, and he comes to us for regular injections.
[AGENT][NEUTRAL] OK, under this policy for services provided in office, we cover up to $500 per day, and that's for the co-insurance and the deductible after the primary insurance processes the claim, but the copay for the office visit is not covered.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, is there a reference number for our 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] My last initial is [PII] and today's date. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] No, ma'am, not at this time.
[AGENT][POSITIVE] OK. Well, I thank you again, [PII], for calling APL. You have a great rest of your day. Bye.
[CUSTOMER][POSITIVE] Thank you. You as well. Bye-bye.
[AGENT][POSITIVE] Thanks.