AccountId: 011433970860
ContactId: 56476cbf-9da8-415c-9fb8-c6d4929365a8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 392140 ms
Total Talk Time (AGENT): 127069 ms
Total Talk Time (CUSTOMER): 85121 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/18/56476cbf-9da8-415c-9fb8-c6d4929365a8_20250418T14:22_UTC.wav
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[AGENT][NEUTRAL] Contacting ATL, my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I was just calling um to see if an individual has an active plan with mental health and patient benefits.
[AGENT][NEUTRAL] I can certainly look that up, and with whom am I speaking, please?
[CUSTOMER][NEUTRAL] My name's [PII].
[AGENT][POSITIVE] Sounding great. Thank you. And what is that policy number that we're looking at, please?
[CUSTOMER][NEUTRAL] It is 02595576.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Is [PII] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And I just need to call back number please in the event that we're disconnected.
[CUSTOMER][NEUTRAL] It's [PII] and I'm at extension [PII].
[AGENT][NEUTRAL] OK, I appreciate that. Thank you. The policy went into effect on [PII]. It is active. So let me see what we have here. This is a hospital indemnity policy. Um, it is uh a limited benefit policy, and so, um, we'll just have to see what it covers.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Checking here.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Most of the benefits.
[AGENT][NEUTRAL] Or for in-hospital services for sickness or, or accidents, so.
[AGENT][NEUTRAL] we have
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Rehabilitation, it's not really the same thing.
[AGENT][NEUTRAL] ROX
[AGENT][NEUTRAL] I'm just checking.
[AGENT][NEGATIVE] Don't see it. No, it doesn't look like it.
[AGENT][NEUTRAL] Uh, there are hospital benefits.
[CUSTOMER][NEGATIVE] Doesn't look like there's any.
[AGENT][NEUTRAL] Yeah, it doesn't look like there's anything.
[CUSTOMER][NEUTRAL] But for mental health?
[AGENT][NEUTRAL] No, it looks like this is all for uh.
[AGENT][NEUTRAL] Looks like this is all uh
[AGENT][NEUTRAL] Um,
[AGENT][NEGATIVE] It would be for sickness or accident. It doesn't look like it's, it has anything for mental health. I'm just not seeing anything.
[AGENT][NEUTRAL] I hear that says that.
[CUSTOMER][POSITIVE] OK, that's what I wanted.
[CUSTOMER][NEUTRAL] It does have a medical ID that's on the card, but you were able to pull him up with that ID number that I gave you just fine.
[AGENT][NEUTRAL] Yes, yes, yeah, these are, these are benefits in the card in there uh and [PII], they're, they're usually uh managed by one or more companies and so the, the number ending in 576 is our number, um, but he can, she can also have other numbers as well, um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Depending on who it is you're calling.
[CUSTOMER][NEUTRAL] Other numbers, OK, um, but for this specific one it's just 6 or sick or accident, no mental health coverage.
[AGENT][NEUTRAL] It doesn't look like it. I'm just not seeing anything. Excuse me just a minute. I'm just gonna look one other place and I'll be right back. Excuse me just one moment.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, I do apologize. I'm just not finding anything for mental health.
[CUSTOMER][NEUTRAL] OK, so that's all I just wanted to confirm no mental health coverage. Um, if we have to submit claims or anything to get a denial, is that the number that's on the card, the [PII] 21704? OK, and then let me just make the payer ID 645566. The card's kind of hard to read.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] That's correct.
[AGENT][NEUTRAL] Uh, that's correct, yes, that's exactly right, yes. And actually, let me give you a, let me give you another address, um, uh, [PII], it's um [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]. And the zip code is [PII] and I would send your claim there.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK perfect OK great all right thank you that was all that I needed then do you have a reference number for our our call?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, my name is [PII]. The first letter of my last name is [PII], and we'll use that in today's date as a reference.
[CUSTOMER][POSITIVE] OK great all right thank you very much.
[AGENT][POSITIVE] OK, thank you for contacting APO