AccountId: 011433970860
ContactId: 4d778a0d-37b2-4d04-baaf-c221dbcaeb52
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 495019 ms
Total Talk Time (AGENT): 96465 ms
Total Talk Time (CUSTOMER): 135516 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/4d778a0d-37b2-4d04-baaf-c221dbcaeb52_20250527T14:05_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling ATL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, my name's [PII]. I am a therapist provider and I had a client reach out to me to start services, and they, uh, gave me this information as their, um, insurance plan, and I wanted to give them information about what to expect for services and coverage. Are you able to give me information on if you guys cover mental health services and if I gave you my billing codes, what you guys cover, what I could tell my client would be their expected cost?
[AGENT][NEUTRAL] Sure, I can verify benefits for you, Ms. [PII]. And what's that policy number, please?
[CUSTOMER][NEUTRAL] Um, the policy number is 02621581.
[AGENT][POSITIVE] Thank you. One moment.
[AGENT][NEUTRAL] And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, and the patient's name, date of birth?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[CUSTOMER][NEUTRAL] And, and unfortunately I, oh, I do have his date of birth. Hold on one moment.
[CUSTOMER][NEGATIVE] I may have to quit do do do do do.
[CUSTOMER][NEUTRAL] Give me one moment.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] I gotta go to a different form.
[CUSTOMER][NEUTRAL] Oh, I
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] So sorry, give me one more, one moment.
[AGENT][NEUTRAL] Oh, you're fine.
[CUSTOMER][NEUTRAL] OK. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. I'm I'm trying to pull up his policy, uh, but show effective date of [PII] of this year and the policy is active.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Um, but let me see if mental health is an exclusion. Give me one moment.
[CUSTOMER][NEUTRAL] Yeah, I was trying to see too because I, I, I, I don't even know from looking at your guys' website how to credential with you guys if you have credentialing, you know, I'm thinking like Blue Cross Blue Shield, right? Like we have to get a networking credential. I didn't know how your insurance works. I've never worked with your insurance before.
[AGENT][NEUTRAL] Well, with our insurance company, we don't have a network, so, um, there's really not much credentialing. Once the claim has been received, then we just add the provider's information in our system and sometimes may require uh a request to W9.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But um,
[AGENT][NEUTRAL] Give me one moment.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] I apologize my computer is running really slow.
[CUSTOMER][NEUTRAL] No, that's, that is OK.
[AGENT][NEGATIVE] I don't think my computer wanna work today.
[AGENT][NEGATIVE] Oh, come on.
[CUSTOMER][NEUTRAL] That is OK. I'm just trying to do whatever research I can on.
[CUSTOMER][NEUTRAL] On my end too.
[AGENT][NEUTRAL] I understand.
[CUSTOMER][NEUTRAL] Yeah, cause I'm even looking at like the multi-plan to like locate a provider and again on there I can see like hospital or family practice, but I don't see anything regarding mental health.
[AGENT][NEUTRAL] Yeah, that's something you may need contact uh multi plan about um.
[AGENT][POSITIVE] Gracious, come on.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 326215.
[AGENT][NEGATIVE] This thing is so slow.
[AGENT][NEUTRAL] Oh OK. I do show that mental or emotional disorder is not is not um covered. It's an exclusion under the plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Just to confirm again, I just like to let my clients know and be very transparent about costs. So just to confirm whether it's myself or they submitted any claims to, there would be no coverage at all at any point.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Correct, because mental health is an exclusion under the policy contract.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, I will make sure to let them know so then they can make whatever best decision for them um so OK thank you very much for your help I greatly appreciate it.
[AGENT][POSITIVE] Oh, you're welcome. And Ms. [PII], thank you so much for being patient with me.
[CUSTOMER][POSITIVE] Yeah no problem you have a great rest of your day.
[AGENT][POSITIVE] Alright you too thank you for calling APL.
[CUSTOMER][NEUTRAL] Yep bye.
[AGENT][NEUTRAL] Mm bye.