AccountId: 011433970860
ContactId: 3ab3e6c5-7fd4-49c0-8606-327d481fee74
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 135899 ms
Total Talk Time (AGENT): 59335 ms
Total Talk Time (CUSTOMER): 69472 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/10/3ab3e6c5-7fd4-49c0-8606-327d481fee74_20250210T19:26_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], how are you? My name is [PII]. I'm calling from a provider's office. Um, I have a patient in office right now. I need to verify their, their policy if it's active and if it covers, um, office visits, please.
[AGENT][POSITIVE] Yes, ma'am. I can assist you with benefits. Could I please get your name one more time and a good callback number?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah, it's
[CUSTOMER][NEUTRAL] Yes, it's [PII] callback number is [PII] and I'm calling from Worldwide Pediatrics. We're the PCP.
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] I have here 02549599 M as in mom, L as in Larry, and 8.
[AGENT][NEUTRAL] Thank you. Now please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] It's [PII], [PII].
[AGENT][NEUTRAL] OK. And just let me advise you that verification of coverage does not guarantee payment of claim. Um, the effective date on this policy was [PII] and the policy is still active.
[AGENT][NEUTRAL] And let's see, for office visits, um, we cover up to 500 per day, and that's for the coinsurance and the deductible after the primary insurance processes the claim, but the co-pay for the office visit is not covered.
[CUSTOMER][NEUTRAL] OK, so co-pay, yeah, because she does have a copay today, so she, it doesn't cover a copay.
[AGENT][NEUTRAL] That's right. If it's, if the service is provided in office, mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, OK, perfect. And this is just, OK, and what kind of premises like what, like a open access self funded PPO gap? What kind of premises?
[AGENT][NEUTRAL] It's a gap plan.
[CUSTOMER][POSITIVE] Gap gap plan perfect perfect. May I have a reference number for this verification?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Um, the reference number is in my name and today's date.
[CUSTOMER][NEUTRAL] OK, so it was easy, right?
[AGENT][POSITIVE] Yeah, that's correct.
[CUSTOMER][POSITIVE] Perfect thank you so much for your help. I appreciate it for your for everything. Thank you.
[AGENT][POSITIVE] Mhm. Thank you, [PII], for calling ATL. Have a great day. Mm bye.
[CUSTOMER][NEUTRAL] Me too.