AccountId: 011433970860
ContactId: 487fc187-61b7-4179-98f1-59f0e3c481f5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 208830 ms
Total Talk Time (AGENT): 102870 ms
Total Talk Time (CUSTOMER): 76262 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/487fc187-61b7-4179-98f1-59f0e3c481f5_20250421T15:52_UTC.wav
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[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, miss. Good, good morning. I'm calling from provider's office. I need to verify benefits for one of my patients.
[AGENT][POSITIVE] Sure, I can check benefits for you. uh, what was your name? I'm sorry?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you. And then I, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Can you give me
[CUSTOMER][NEUTRAL] OK. Can you give me one second? Uh, I'm sorry, um, what are you asking me for?
[AGENT][NEUTRAL] Oh, sure.
[AGENT][NEUTRAL] Um, a callback number in case we're disconnected please.
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you. And then did you have that policy number?
[CUSTOMER][NEUTRAL] Yes, it is 12, um, I'm sorry. Yeah, 1236669.
[CUSTOMER][NEUTRAL] MLA.
[AGENT][NEUTRAL] Got it. And then what was the name and date of birth for the member, please?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] And her date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. Uh, so this policy terminated, uh, [PII]. If you'll give me one moment I'll see if she might have one that's active, it could just be a different policy number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, she does have one that is currently active. Uh, let me know when you're ready and I can give you that updated policy number.
[CUSTOMER][POSITIVE] Please, yes, thank you, I'm ready.
[AGENT][NEUTRAL] OK, of course that is 02.
[AGENT][NEUTRAL] 56.
[AGENT][NEUTRAL] 6386.
[CUSTOMER][NEUTRAL] 86
[AGENT][NEUTRAL] 8, the number 86.
[CUSTOMER][POSITIVE] OK, thank you, [PII].
[AGENT][NEUTRAL] Alrighty, of course, uh, so this one is currently active. Uh, that effective date was [PII], and we we needing to look at, uh, inpatient or outpatient benefits?
[CUSTOMER][NEUTRAL] I'm looking for the office uh if if she have um.
[CUSTOMER][NEUTRAL] In uh outpatient of uh specialist office visit if it's covered or not.
[AGENT][NEUTRAL] Specialist office. OK, got you, yes, of course, um, so this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays.
[AGENT][NEUTRAL] And uh of course I will let you know verification of coverage is not a guaranteed payment for claims uh so this policy does not have uh any office visit benefits.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, no office. And for outpatient procedure?
[AGENT][NEUTRAL] That is, uh, the outpatient benefit is $500 max per calendar year.
[CUSTOMER][NEUTRAL] N for calendar.
[CUSTOMER][POSITIVE] Wonderful. I really appreciate that and thank you so much. I think that's all. Can you provide me a reference number for a call?
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] Sure, that would just be my first name, last initial, and today's date and so my name is spelled [PII] last initial is [PII], and there wasn't anything else I can help you with?
[CUSTOMER][POSITIVE] No, that's all thank you.
[AGENT][POSITIVE] OK, yeah, thanks for calling [PII] have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you same to you bye bye. Thank you.
[AGENT][POSITIVE] Thanks bye bye.
[CUSTOMER][NEUTRAL] Bye-bye.