AccountId: 011433970860
ContactId: 6878e097-8196-448d-a7df-795ef1853f23
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 221580 ms
Total Talk Time (AGENT): 98591 ms
Total Talk Time (CUSTOMER): 81261 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/6878e097-8196-448d-a7df-795ef1853f23_20250513T14:28_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. My name is [PII], and I'm calling from a provider's office to verify some benefits for a member, please.
[AGENT][POSITIVE] All right, I'm happy to check on benefits for you today. Can I get the patient's policy number?
[CUSTOMER][NEUTRAL] 60801.
[AGENT][NEUTRAL] That's actually our payer ID.
[CUSTOMER][NEUTRAL] Payer ID? Oh, let me see really quick because.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] They put this me right here.
[CUSTOMER][NEUTRAL] On the patient's account, let me see um.
[CUSTOMER][NEUTRAL] OK, I'm sorry, I have it here. It's uh for outpatient. OK, uh 02545452 ML 8.
[AGENT][NEUTRAL] That's OK.
[AGENT][POSITIVE] OK, thank you so much. Let me pull this up here.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] All right. And then if I could get the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] Thank you so much. So the patient is active. Effective date is [PII].
[AGENT][NEUTRAL] We are the members' secondary insurance, so this covers deductible, co-pay, co-insurance, the primary does not.
[CUSTOMER][NEUTRAL] OK, yeah, I'm calling because, um, this patient has a copay uh for an allergy testing that he's gonna have with us in the all in the specialist's office, yeah, and allergy treatment. Does it cover anything related to allergy testing and allergy treatment, any copays?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, it, I know it would definitely cover proba it would cover the testing. Let me just see if it's gonna cover, yeah, but let me see if it's gonna cover the office visit fee cause sometimes they don't cover the fee for the office visit.
[CUSTOMER][NEUTRAL] The testing.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Let me see one moment.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. So it's gonna cover any sort of treatment or testing in the physician's office. It's just not gonna cover the physician office visit fee.
[CUSTOMER][NEUTRAL] OK, but, uh, the testing of the treatment should be covered.
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK perfect and up to how much is that?
[AGENT][NEUTRAL] Let me see what their outpatient benefits are here, one moment.
[AGENT][NEUTRAL] Uh, on this patient plan it looks like their outpatient benefit max is going to be 3000 for the calendar year, and they have that full amount remaining.
[CUSTOMER][NEUTRAL] For many, OK.
[CUSTOMER][POSITIVE] Thank you so much [PII], and do you have a reference number please?
[AGENT][NEUTRAL] Mhm. Call reference is my name with my last initial, then today's date. My name again is [PII], that's [PII], last initial [PII] and today's date.
[CUSTOMER][POSITIVE] OK, thank you so much. OK have a nice day.
[AGENT][NEUTRAL] You, you too. Bye-bye.