AccountId: 011433970860
ContactId: 35f3afd5-34ca-431e-bd39-5705038f0bd0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 174470 ms
Total Talk Time (AGENT): 75633 ms
Total Talk Time (CUSTOMER): 72044 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/13/35f3afd5-34ca-431e-bd39-5705038f0bd0_20250613T12:10_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, good morning, [PII]. My name is [PII]. I'm calling from Tmont Comprehensive Pain Management Group.
[CUSTOMER][NEUTRAL] And I have a question regarding one of the members.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] I'm sure, [PII] I can assist you with um benefits. Um, first, could I get your name and I go, well, I got your name. Could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] It's 021-37671.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] The patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK. 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. And what's your question?
[CUSTOMER][NEUTRAL] Yes, the patient's coming in for a procedure and uh she has EDMS as primary, of course, and I always wondered, she has not met her deductible yet.
[CUSTOMER][NEUTRAL] So do you guys help pay anything toward her deductible?
[AGENT][NEUTRAL] OK, this is for an office visit?
[CUSTOMER][NEUTRAL] This is actually for a procedure.
[AGENT][NEUTRAL] OK. And will it take place in the office or in the um outpatient facility?
[CUSTOMER][NEUTRAL] It will take place in the office.
[AGENT][NEUTRAL] OK. Yes, ma'am. For services provided in office, we cover up to $500 per day um for the co-insurance and the deductible, but any co-pays for office visits are not covered.
[CUSTOMER][NEUTRAL] So y'all, y'all did pay $500 toward her deductible per day.
[AGENT][NEUTRAL] Um, yes, ma'am, for, um, services that the primary insurance does cover and it um has to be related to an illness or an injury.
[CUSTOMER][NEGATIVE] Illness and it is their, they turn i illnesses due to um back pain.
[CUSTOMER][NEUTRAL] Back issues. So let me ask you this, um, can you have a reference number for me?
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Um, yes, the reference number is my name and today's date. Um my name is spelled [PII].
[CUSTOMER][POSITIVE] Mhm. And you know what I done good with spelling your name. I got it exactly correct.
[AGENT][POSITIVE] Oh good.
[CUSTOMER][POSITIVE] Yeah, I know, I hit it right on the spot this time.
[AGENT][NEUTRAL] It rarely happens.
[CUSTOMER][POSITIVE] Well, thank you so much and you have a wonderful day.
[AGENT][POSITIVE] You do the same, [PII] um I thank you for calling APL. Mm bye.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.