AccountId: 011433970860
ContactId: 3da3333d-692b-4ce2-9ec2-1b04b3fc9f25
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 151880 ms
Total Talk Time (AGENT): 77948 ms
Total Talk Time (CUSTOMER): 49150 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/3da3333d-692b-4ce2-9ec2-1b04b3fc9f25_20250218T20:13_UTC.wav
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[CUSTOMER][NEUTRAL] Not a.
[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. I'm calling from Cardiology Healthcare of South Florida. Um, I just wanna verify the benefits and eligibility of a patient.
[AGENT][NEUTRAL] Yeah, I can check eligibility and benefits for you. Uh, what was your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, and can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you. Do you have the policy number?
[CUSTOMER][NEUTRAL] Um, yes, it's 025.
[CUSTOMER][NEUTRAL] 191.
[CUSTOMER][NEUTRAL] 66.
[AGENT][NEUTRAL] OK, thank you. And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Um, his name is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And his date of birth is [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that. Uh, so this policy is active. Effective date was um [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays, and we're waiting to look at the outpatient benefits.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims, uh, so the outpatient benefit is on a per calendar day basis, so it pays $300 max per calendar day.
[CUSTOMER][NEUTRAL] OK, so does that cover if he has a co-payment for a specialist, does it cover that his co-payment?
[AGENT][NEUTRAL] Um, let me see.
[AGENT][NEUTRAL] Office visits, give me just a moment. OK, so for this policy, um.
[AGENT][NEUTRAL] Office visits are not covered, however, treatment in office could be the visit itself would not be.
[CUSTOMER][NEUTRAL] OK, so any studies, yes, and there is a no, OK.
[CUSTOMER][POSITIVE] Good
[AGENT][NEUTRAL] Right, treatment in office could be.
[CUSTOMER][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] It's just the visit itself so it was just like a consultation or something like that.
[CUSTOMER][NEUTRAL] Oh OK.
[AGENT][NEUTRAL] OK, was there anything else I can help you with?
[CUSTOMER][NEUTRAL] Alright, um
[CUSTOMER][NEUTRAL] No, that'll be it.
[AGENT][POSITIVE] OK, well thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you you too.
[AGENT][POSITIVE] Thank you, bye bye.
[CUSTOMER][NEUTRAL] Bye bye.