AccountId: 011433970860
ContactId: 7392fcd5-342e-4017-b880-cda435e20802
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 208860 ms
Total Talk Time (AGENT): 110786 ms
Total Talk Time (CUSTOMER): 57791 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/15/7392fcd5-342e-4017-b880-cda435e20802_20250515T13:15_UTC.wav
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[AGENT][POSITIVE] Thank you for contacting. My name is [PII]. How may I help you?
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hi, I'm calling for benefits and eligibility, and I'm so sorry you said your name is?
[AGENT][NEUTRAL] Yes, my name is [PII], and I'm sorry, I didn't catch your name.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, OK, thank you. And um what is that policy number that we're looking at today, [PII]?
[CUSTOMER][NEUTRAL] 15494
[AGENT][NEUTRAL] 15494.
[CUSTOMER][NEUTRAL] The patient
[CUSTOMER][NEUTRAL] Yes, the patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Let's see what
[AGENT][NEUTRAL] I wonder who this is.
[AGENT][NEUTRAL] Let me check here and while I'm doing that if I could just have a callback number please the event we disconnected.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It is pretty early in the morning, isn't it? It's too early for this.
[CUSTOMER][NEUTRAL] Mm, mhm.
[AGENT][NEUTRAL] OK. The number that you gave me is her group number and that's fine. I was able to find her policy by that, but um if you have uh a moment, I can give you her policy number before we get into benefits and eligibility.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] That would be great. Yes, yes, if you're able to go ahead and provide that for me, please.
[AGENT][NEUTRAL] Yes, it's 01.
[AGENT][NEUTRAL] 480315. Now I'm having a little trouble with my phone, so I'm just gonna repeat it. 01.
[AGENT][NEUTRAL] 48315. That went into effect on [PII] and it is active. Now you mentioned the benefits before. Would you like the outpatient benefits?
[CUSTOMER][NEUTRAL] Yes, so
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, for outpatient and office visits, so just to confirm, you said the member ID is gonna be 01480315?
[AGENT][NEUTRAL] That is it, yes. Now, for outpatient hospital.
[AGENT][NEUTRAL] The policy will pick up the deductible, co-payment or co-insurance from the major medical.
[AGENT][NEUTRAL] Up to $500 per calendar day. That's just a verification of the benefits, not a guarantee of payment, but that is per calendar day. But there are no benefits for a physician's office, so not the office visit, not treatment. There's nothing within a physician's office that is covered. So this is strictly for hospitals.
[CUSTOMER][NEUTRAL] OK, so
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, so it's, um, plan pays up to $500 per calendar day for outpatient office visit not covered.
[AGENT][NEUTRAL] That's right, yes. So if you're having an outpatient surgery, the ER urgent care is good, but not for office visits.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alrighty and the reference number please?
[AGENT][NEUTRAL] My name is [PII], and the first letter of my last name is [PII]. We're gonna use that today's date as a reference. Is there anything else at all that I can help with?
[CUSTOMER][POSITIVE] No, thank you so much. You have a great rest of your day.
[AGENT][POSITIVE] Thanks for contacting AT. Have a good day.