AccountId: 011433970860
ContactId: 4a9234c8-1870-41d2-8da8-68389ecd8bd2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 202919 ms
Total Talk Time (AGENT): 92645 ms
Total Talk Time (CUSTOMER): 72517 ms
Interruptions: 1
Overall Sentiment: AGENT=1.5, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/4a9234c8-1870-41d2-8da8-68389ecd8bd2_20250213T20:49_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, I'm calling to check uh benefits for a patient for a outpatient procedure.
[AGENT][NEUTRAL] OK. Sure, I can assist you with benefits. And may I have your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And a callback number just in case we get disconnected, Ms. [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] All right, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Um, do you want the one for the out outpatient benefits cert number? It's 01 01578526 M as in Mary, L as in Larry 8.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Mhm. Yes, that will be perfect.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] It's [PII] um oh no this is for his wife sorry.
[CUSTOMER][NEUTRAL] [PII] date of birth [PII].
[AGENT][NEUTRAL] OK perfect thank you. Alright, and before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer and let's see we have an outpatient maximum of.
[AGENT][NEUTRAL] 2500 per cover person per calendar year.
[CUSTOMER][NEUTRAL] That's the deductible or the?
[AGENT][NEUTRAL] That is the maximum benefit. This is a secondary supplemental plan to the major medical. So we help with deductibles, co-payment, and co-insurance. Uh, we pay outpatient facilities.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] Oh, OK, so that is you said it's 250, that's the, the max that.
[AGENT][NEUTRAL] 2500 per year.
[CUSTOMER][NEUTRAL] 0, 2500.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Per year.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and has the patient met any of this or or no I mean well used any of this?
[AGENT][NEUTRAL] I can check, I can check and see if she has any one moment.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] No, they have not used their benefits for [PII] as of as of today.
[AGENT][NEUTRAL] Do you have the full amount available.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect, perfect. Alright, well I thank you very much. Is there a reference number for this call?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will. Do you need the spelling of my name or any other information?
[CUSTOMER][POSITIVE] Yes, yes, please.
[AGENT][NEUTRAL] Sure. That's [PII]. Last initial [PII].
[CUSTOMER][POSITIVE] OK, thank you very much have a wonderful day.
[AGENT][POSITIVE] You're welcome, Ms. [PII], and thank you for calling ATL. Have a good day. Bye-bye.
[CUSTOMER][NEUTRAL] Bye you too bye.
[AGENT][POSITIVE] Thank you.