AccountId: 011433970860
ContactId: 588e48e4-1ba5-4751-9b0b-03242c0159b8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 157770 ms
Total Talk Time (AGENT): 81466 ms
Total Talk Time (CUSTOMER): 43564 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=1.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/588e48e4-1ba5-4751-9b0b-03242c0159b8_20250320T15:33_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm calling to get um eligibility and benefits for a patient uh for outpatient benefits.
[AGENT][POSITIVE] All right, I'm happy to check on eligibility and benefits today. Can I get the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, it is 02496158.
[AGENT][POSITIVE] Thank you. And then if I could grab your first name and a callback number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And the phone number is [PII] and it's option 3 for verification.
[AGENT][POSITIVE] Thank you so much. Can I get the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Thank you. So the patient is active. The effective date is [PII]. We are the member's secondary insurance, so it does cover deductible, co-pay, co-insurance, primary does not.
[AGENT][NEUTRAL] And it looks like.
[AGENT][NEUTRAL] You want their outpatient benefit.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Are they coming in for like an office visit or?
[CUSTOMER][NEUTRAL] Um, outpatient, um, they're having a endoscopy and colonoscopy.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I just need to pull this policy. I apologize, one moment.
[CUSTOMER][NEUTRAL] That's OK.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] So it looks like it's a combined inpatient and outpatient maximum, so it's 2,500 uh 2500 per covered person per calendar year for both inpatient and outpatient benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And have they met anything towards that?
[AGENT][NEUTRAL] Let me see here one moment.
[AGENT][NEUTRAL] I'm not showing [PII] has used anything for [PII].
[CUSTOMER][POSITIVE] Perfect thank you so much. I appreciate your help. May I have a reference um reference number for this call?
[AGENT][NEUTRAL] Absolutely. Call references my name with my last initial, then today's date. My name again is [PII], that's [PII], last initial [PII], and then today's date.
[CUSTOMER][POSITIVE] Thank you. I hope you have a great day.
[AGENT][NEUTRAL] You too bye bye.
[CUSTOMER][POSITIVE] Thank you bye bye.