AccountId: 011433970860
ContactId: 3f97c177-f7a3-43a2-b8cf-dda669a5db1f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 162119 ms
Total Talk Time (AGENT): 73466 ms
Total Talk Time (CUSTOMER): 60934 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/3f97c177-f7a3-43a2-b8cf-dda669a5db1f_20250414T12:42_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yes, good morning. I'm calling for benefits and eligibility please for one of our patients.
[AGENT][POSITIVE] Yes, ma'am. I can assist you with benefits. Um, first, could I get your name and a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, my name is [PII]
[CUSTOMER][NEUTRAL] And the best callback number is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. Now, could I get the policy number, please?
[CUSTOMER][NEUTRAL] Yes, it's gonna be 02502535 M as in Mike L as in Liam 7.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] The patient's name is gonna be [PII].
[CUSTOMER][NEUTRAL] [PII]?
[CUSTOMER][NEUTRAL] And the date of birth, give me one moment, please.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright it's gonna be [PII].
[AGENT][NEUTRAL] just submit advise you the verification of coverage. It does not guarantee payment of claims. The effective date on this policy was [PII]. The policy is still active. And is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Of outpatient benefits and it's for an office visit as well, specialist office visit.
[AGENT][NEUTRAL] OK, for services provided in office, we cover up to $2500 per calendar year and that's for the co-insurance and the deductible after the primary insurance processes the claim and for the specialist office visit, we cover up to $50 per visit and he gets $4 per calendar year.
[CUSTOMER][NEUTRAL] OK, so $50 per visit, um, for the office visit, 4 visits, how much has been accumulated?
[AGENT][NEUTRAL] Um, so far, he hasn't used any, so all 4 is available so far.
[CUSTOMER][NEUTRAL] And then you said for the outpatient surgery the plan pays up to $2500 per calendar year?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] And how much has been accumulated from that?
[AGENT][NEUTRAL] OK, so far, let's see. $310.
[CUSTOMER][POSITIVE] Thank you so much [PII] and the reference number please?
[AGENT][NEUTRAL] So the reference number, you can use my name and today's date. And is there anything else I can assist you with?
[CUSTOMER][POSITIVE] That is all thank you have a great rest of your your Monday.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling ATL. Mm bye.
[CUSTOMER][NEUTRAL] Bye.