AccountId: 011433970860
ContactId: 7621800c-f802-4a14-b152-b1dd785da3b8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 224300 ms
Total Talk Time (AGENT): 93001 ms
Total Talk Time (CUSTOMER): 50554 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/20/7621800c-f802-4a14-b152-b1dd785da3b8_20250520T15:00_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. I need to check eligibility on a pension.
[AGENT][NEUTRAL] OK, I could check the eligibility.
[CUSTOMER][NEUTRAL] I need to check um
[AGENT][NEUTRAL] Go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] OK, can you check, can you check if the patient has accumulations for the gap?
[AGENT][NEUTRAL] For their gap you said? I'm sorry.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Yes, uh, so we're needing to see if any benefits have been used, is that what you mean?
[CUSTOMER][NEUTRAL] OK, yes ma'am.
[AGENT][POSITIVE] Sure, I can definitely excuse me, I can definitely check that for you. Um, what was your name? I'm sorry.
[CUSTOMER][NEUTRAL] Mm, OK.
[CUSTOMER][NEUTRAL] [PII]'s and yours?
[AGENT][NEUTRAL] It is uh [PII]
[AGENT][POSITIVE] And [PII], can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Yes, it's um 02061384.
[AGENT][NEUTRAL] OK, and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] It's [PII] date of birth [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that. Uh, so this policy is active. Effective date was [PII], and this is, uh, as it is a secondary medical policy, it is designed to help with co-pay, deductible and co-insurance after major medical pays.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Give me just a moment, let me take a look here. I'm gonna get his uh policy pulled up here was where we need to look at the benefit for uh inpatient or outpatient?
[CUSTOMER][NEUTRAL] This is for outpatient ambulatory.
[AGENT][NEUTRAL] OK, OK. Thank you. One moment, please.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Bear with me just a moment. I appreciate your patience.
[CUSTOMER][NEUTRAL] Mhm OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, well, of course, I will let you know verification of coverage is not a guarantee of payment for claims. Uh, I am not showing that this policy has
[AGENT][NEUTRAL] Any outpatient benefits, it's only going to be inpatient for this policy.
[CUSTOMER][NEUTRAL] OK, so the patient has no outpatient benefits.
[AGENT][NEUTRAL] Correct. I did have to pull up that policy to be sure, but yes, they only have inpatient benefits.
[CUSTOMER][POSITIVE] Oh OK perfect can I have a reference call?
[AGENT][NEUTRAL] Sure, that would just be my first name, last initial, and today's date. Uh, so my last initial is [PII], and was there anything else I could help you with?
[CUSTOMER][POSITIVE] No ma'am, thank you so much.
[AGENT][POSITIVE] Of course, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you bye bye.