AccountId: 011433970860
ContactId: 6a0d7d47-2171-494a-94ae-55ae14c1d7f3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 183880 ms
Total Talk Time (AGENT): 75627 ms
Total Talk Time (CUSTOMER): 83650 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/6a0d7d47-2171-494a-94ae-55ae14c1d7f3_20250221T14:19_UTC.wav
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[AGENT][POSITIVE] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, um, my name is [PII]. I'm calling from Orthopedic Medical Group Surgery Center with a question about, uh, eligibility and benefits of one of your clients. Um, can I please ask you to spell your name for please, for me, please?
[AGENT][NEUTRAL] Um yes, my name is [PII]. It's spelled [PII] My last initial is [PII] and sure [PII], I can assist you with benefits. And first, I'll need to go callback number just in case we're disconnected.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] 247-9243
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII] and the policy is still active.
[AGENT][NEUTRAL] And is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Uh, this is for ambulatory surgery, so that would be like outpatient.
[AGENT][NEUTRAL] OK. Yes, ma'am. Under this policy, we cover up to $500 per day and that's for the co-pay, the coinsurance, and the deductible after the primary insurance processes the claim.
[CUSTOMER][NEUTRAL] OK, so it's 500 per day. So if it's ambulatory, uh, or outpatient, it would limit the.
[CUSTOMER][NEUTRAL] To 500. Do I understand that correctly? OK, OK, so that was [PII], the effective date, yes?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] Oh thank you so much. Yes, so I have everything. Um, do you have any reference number for our conversation?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. Um, is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] No, thank you. That was all. Oh no, no, no, one question, uh, I want to confirm uh the, the address for the claim.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Where the medical provider can uh send the claim.
[AGENT][NEUTRAL] OK, yes, ma'am. Our mailing address is [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that's in [PII]?
[CUSTOMER][NEUTRAL] Was it, ah, is it?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yes, [PII], yes, yes, I just wanted to confirm. Thank you so much. That would be all from me. Enjoy the rest of your day.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling ATL. Mhm bye.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] OK.