AccountId: 011433970860
ContactId: 57aa4286-c85b-4f5c-b88f-c4fc2471c194
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 263690 ms
Total Talk Time (AGENT): 129216 ms
Total Talk Time (CUSTOMER): 133482 ms
Interruptions: 7
Overall Sentiment: AGENT=1, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/06/57aa4286-c85b-4f5c-b88f-c4fc2471c194_20250606T18:16_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling ATL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] But the date of birth?
[CUSTOMER][NEUTRAL] Hi, good afternoon. I'm sorry, I can't hear you, [PII], can you please repeat it for me?
[AGENT][NEUTRAL] My name is [PII]. That's [PII].
[CUSTOMER][NEUTRAL] Excuse me?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh thank you. So hi, um, I'm calling for [PII] yes just a specialist. I'm calling because I want to know, um, benefits and eligibility for a member please.
[AGENT][NEUTRAL] No
[AGENT][NEUTRAL] OK, sure, I can assist you with benefits and eligibility and may I have your name?
[CUSTOMER][NEUTRAL] Yes, my name is [PII].
[CUSTOMER][NEUTRAL] Last name, uh, initial is [PII].
[AGENT][POSITIVE] Thank you, Miss [PII]. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] I'm sorry, I can't hear you.
[AGENT][NEUTRAL] A callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Yeah, the colorful paper
[AGENT][NEUTRAL] Thank you and may I have the patient's policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] Yes, uh 01868788.
[AGENT][NEUTRAL] Thank you. May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yes, [PII], uh, date of birth is uh [PII].
[AGENT][NEUTRAL] OK, thank you. And you said you need eligibility and benefits today. What type of service is being rendered for benefits?
[CUSTOMER][POSITIVE] He's using and everything comes to sight that's thank you.
[CUSTOMER][NEUTRAL] Yes, I want to know because the last time I called, um, I think I spoke with [PII], she told me only uh the plan is a supplement plan, but I don't know if it's uh for uh categories like plan A, B, or.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh what uh uh what benefit does uh the patient has on this, um, insurance?
[AGENT][NEUTRAL] OK, um, yes, OK.
[CUSTOMER][NEUTRAL] I if you if you want to call.
[AGENT][NEUTRAL] Are they gonna have be getting testing? Is this considered an office or is this considered an outpatient facility?
[CUSTOMER][NEUTRAL] Hello sir.
[CUSTOMER][NEUTRAL] Yeah, no, uh, here with us is uh office specialist.
[AGENT][NEUTRAL] Offices specialist, OK.
[AGENT][NEUTRAL] All right. OK. Let me go ahead and get that information. And Miss [PII], this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. This is a secondary supplemental plan to the major medical. So this one is not a Medicare supplemental, it's a um secondary to the major medical, OK? Um, so there's no letter. Um, on this one, let's see.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm. So we cover for procedures done in the office. We do not cover the office visits, so we only cover the procedures like if there's any injections, CT scan, MRIs, and any testing, that will be considered under the benefits of the outpatient, which is 2500 per covered person per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, uh, can you repeat it for me the amount?
[AGENT][NEUTRAL] Sure, that's 2550.
[CUSTOMER][NEUTRAL] 150?
[AGENT][NEUTRAL] 2550, 550.
[CUSTOMER][NEUTRAL] 0 5500. OK, thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, uh, and the effective date for this, um, insurance?
[AGENT][NEUTRAL] Yeah, OK. We have an effective date of, let's see, [PII] and it is active at the moment.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, so, um, can you please uh give me a reference number for this call?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will.
[AGENT][NEUTRAL] Um, do you need the spelling or any other information, Miss [PII]?
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][POSITIVE] No, that's it. Thank you so much.
[AGENT][POSITIVE] OK. You're welcome and thank you for calling APL. You have a good afternoon and good weekend.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Goodbye.