AccountId: 011433970860
ContactId: 602acddf-f3ee-4d81-b156-30bb3afb1e14
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 319339 ms
Total Talk Time (AGENT): 140020 ms
Total Talk Time (CUSTOMER): 94844 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/17/602acddf-f3ee-4d81-b156-30bb3afb1e14_20250617T20:22_UTC.wav
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[AGENT][POSITIVE] Afternoon, thank you for calling ATL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello? Hi, I wanted to call and
[AGENT][NEUTRAL] Hello.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'm sorry, I was calling to see what the um.
[CUSTOMER][NEUTRAL] Policyholder benefits is as a secondary.
[AGENT][POSITIVE] OK, sure. I can assist you with benefits. May I have your name and a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure [PII] and last name [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's the callback number, Ms. [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. And what's the name of the facility for my notes, [PII]?
[CUSTOMER][NEUTRAL] I can't hear you. What is, what is it?
[AGENT][NEUTRAL] What is the name of the facility?
[CUSTOMER][NEUTRAL] Hollywood dermatology.
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Um 0193700.
[CUSTOMER][NEUTRAL] The number 4, M as in Mary, L as in Larry, the number 8.
[AGENT][NEUTRAL] Thank you. And may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] The name is.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Curtains shorts. I don't know if I'm probably saying it wrong, butchering it, sorry.
[AGENT][NEUTRAL] It's fine. It's fine. No problem. What's the date of birth?
[CUSTOMER][NEUTRAL] Um, and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. All right. And you said you need benefits and this is for a specialist, correct?
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, before I give you any benefits.
[CUSTOMER][NEUTRAL] This is the
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] I just wanted to see what what do you cover for as far as for the primary.
[AGENT][NEUTRAL] OK. All right. Before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. We have an effective date of [PII]. It is active and this is one of our secondary supplemental plan to the major medical.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And with this one, we cover the office procedures. Um, we do not cover the office visits, so it's only gonna be for the procedures done in office. And this is subject to the outpatient maximum of 1500 per covered person per calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, you said the, what is it, the out of pocket?
[AGENT][NEUTRAL] The maximum benefit is 1500 per covered person per calendar year.
[CUSTOMER][NEUTRAL] 1500, that is the max that you pay for cover procedures, right?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Correct, it's for procedures done in office and applied towards the deductible co-payment of coinsurance from the major medical.
[AGENT][NEUTRAL] Hello.
[AGENT][NEUTRAL] Ms. [PII].
[CUSTOMER][NEUTRAL] Cover the insurance. I don't understand. OK, can you repeat that one more time? Yes, can you repeat that one more time because I'm just typing everything in.
[AGENT][NEUTRAL] Hello, Ms. [PII]. Can you hear me?
[AGENT][NEUTRAL] Yes, the outpatient maximum is 1500 per covered person per calendar year, and this is to help with the co-payment, co-insurance and deductible for office procedures only. Office visits are not covered.
[AGENT][NEUTRAL] Hello Ms. [PII], are you still there?
[CUSTOMER][NEUTRAL] Yes, so you said um office visits are not covered?
[AGENT][POSITIVE] Mm. Correct.
[CUSTOMER][NEUTRAL] No
[AGENT][NEUTRAL] We only cover procedures done in office.
[CUSTOMER][POSITIVE] OK, you guys only cover procedures. All right, great, thank you so much have a great day. Can I have a reference number please?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] We do have reference numbers. You can use my name in today's date if you will. Do you need the spelling of my name or any other information?
[CUSTOMER][NEUTRAL] Spelling of the name, please?
[AGENT][NEUTRAL] OK, that's [PII]. That's initial [PII].
[CUSTOMER][NEUTRAL] So I'm
[AGENT][NEUTRAL] So, um, yes.
[CUSTOMER][POSITIVE] Alrighty, thank you so much.
[AGENT][POSITIVE] You're welcome and thank you for calling ATL.
[CUSTOMER][NEUTRAL] Wait.