AccountId: 011433970860
ContactId: 502c3920-e3e0-46e1-94b2-c29c57de3272
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 141699 ms
Total Talk Time (AGENT): 87719 ms
Total Talk Time (CUSTOMER): 41141 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/502c3920-e3e0-46e1-94b2-c29c57de3272_20250512T14:09_UTC.wav
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[AGENT][POSITIVE] Thank you for calling this is. How can I help you?
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Yeah, hi, I need to verify benefits on a patient's gap please.
[AGENT][POSITIVE] Um, yes, ma'am. I can assist you with benefits. Um, first, I'll need your name and a good callback number.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. Now I need the policy number, please?
[CUSTOMER][NEUTRAL] 02572.
[CUSTOMER][NEUTRAL] 353.
[AGENT][NEUTRAL] Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII]. Her date of birth is [PII].
[AGENT][NEUTRAL] OK, and just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII]. The policy is still active.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] I need inpatient, outpatient and also office visits. Does it cover co-payments?
[AGENT][NEUTRAL] OK. Yes, ma'am. For inpatients, we cover up to 8150 per calendar year and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim. Um, that's for inpatient.
[AGENT][NEUTRAL] And for outpatient, we also cover up to 8150 per calendar year for the co-pay, the co-insurance, and the deductible after the primary insurance processes declined. And um let's see, for office visits, um we cover the co-insurance and the deductible, but we don't cover the co-pay for the office visit.
[CUSTOMER][NEUTRAL] No copay, OK.
[AGENT][NEUTRAL] Right, for office physics.
[CUSTOMER][NEUTRAL] Alright, alright, what is your name?
[AGENT][NEUTRAL] It's [PII]. Um it's spelled [PII] and my last initial is [PII]. Is there anything else I can assist you with?
[CUSTOMER][POSITIVE] No, that'll be all. Thank you so much for your help.
[AGENT][POSITIVE] OK, thank you, [PII] for calling ATL. You have a great day. Mm bye.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] OK, thank you.