AccountId: 011433970860
ContactId: 768a1b86-d855-4640-a97d-74f9c0b22a6a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 183369 ms
Total Talk Time (AGENT): 89387 ms
Total Talk Time (CUSTOMER): 44109 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/07/768a1b86-d855-4640-a97d-74f9c0b22a6a_20250107T15:32_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from a provider's office to get benefits for members.
[AGENT][NEUTRAL] OK, yeah, I can look at benefits for you, [PII]. Uh, can I get a callback number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] Thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, it is going to be 02583654.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right. And uh what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] The name is [PII].
[AGENT][NEUTRAL] Do you have the date of birth?
[CUSTOMER][NEUTRAL] Uh yes, it is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. Uh, so this policy is active. Effective date was [PII].
[AGENT][NEUTRAL] Give me one moment here. Let me get that pulled up. So this is a limited indemnity medical plan. So it is designed to just pay a set dollar amount per procedure or office visit. And of course I will let you know verification of coverage is not a guarantee of payment for claims. Um, what were we needing to, what kinds of benefits were we needing to look at, Priscilla?
[CUSTOMER][NEUTRAL] I need to know if they have bariatric surgery benefits.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] I'm sorry, what kind of surgery was it?
[CUSTOMER][NEUTRAL] Bariatric surgery, weight loss?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Is it in, I know this is gonna sound funny, but is this more of an elective surgery or is this going to be in regards to an acne or I'm sorry, a sickness or anything?
[CUSTOMER][NEUTRAL] No, this is an elective surgery.
[AGENT][POSITIVE] It is elected OK.
[AGENT][NEUTRAL] Bear with me just a moment, I believe.
[AGENT][NEUTRAL] The surgeries they have are only going to be in regards to an accident or a sickness or the covered surgeries here.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEGATIVE] Yeah, for something like that, it would just be um the accident or sickness, so that's not going to be covered.
[CUSTOMER][NEUTRAL] OK perfect do you have a call reference number?
[AGENT][NEUTRAL] Yeah, it would just be my first name, last initial, and today's date. And so my name is spelled [PII] Was there anything else I could help you with, Priscilla?
[CUSTOMER][POSITIVE] Nope, that is it thank you again.
[AGENT][POSITIVE] Alright, yeah, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you you as well.
[AGENT][POSITIVE] Thank you bye bye.
[CUSTOMER][NEUTRAL] Bye bye.