AccountId: 011433970860
ContactId: 6f847da4-a6bb-40b7-a907-d4217262bfd9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 188399 ms
Total Talk Time (AGENT): 76071 ms
Total Talk Time (CUSTOMER): 79205 ms
Interruptions: 2
Overall Sentiment: AGENT=1.5, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/6f847da4-a6bb-40b7-a907-d4217262bfd9_20250414T13:09_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APR. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] [PII], this is [PII], and I'm calling from a primary care office in [PII], and I was trying to verify benefits for this insurance we have never dealt with before, um, so I was wanting to verify that if possible with you.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, sure, [PII], I can assist you with benefits. Um, first, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, it's area code [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Um, policy certificate number is 026.
[CUSTOMER][NEUTRAL] 12541.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] Date of birth is [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]. The policy is still active and is this for um an office visit or inpatient or outpatient services?
[CUSTOMER][NEUTRAL] It's for an uh inpatient office visit.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, I'm showing under this policy, this is a limited hospital indemnity um policy, but we do cover some outpatient services and I'm showing for all um outpatient visits, including office visits, we cover up to $50 per visit and she gets $4 per calendar year.
[CUSTOMER][NEUTRAL] OK, and has she had any so far?
[AGENT][NEUTRAL] Let's see, one moment.
[AGENT][NEUTRAL] Um, no, ma'am. So far she hasn't used any of the office visits.
[CUSTOMER][NEUTRAL] OK, and so for limited she gets out limited outpatient and you apply $50 toward that visit.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, and then we mail our claims to [PII].
[AGENT][POSITIVE] Yes, ma'am. That's correct. And we also have a pairer ID.
[CUSTOMER][NEUTRAL] And what is that payer ID honey?
[AGENT][NEUTRAL] It is 645-56.
[CUSTOMER][POSITIVE] Thank you so much. Alright, I appreciate your help, Miss [PII] and no, not at this time. Thank you so much.
[AGENT][POSITIVE] OK, thank you, [PII]. Is there anything else I can assist you with?
[AGENT][POSITIVE] OK, thank you again for calling ATL. Have a great rest of your day. Mm bye.
[CUSTOMER][NEUTRAL] You as well bye bye.
[AGENT][NEUTRAL] OK