AccountId: 011433970860
ContactId: 78fb53b6-b10d-439a-92c0-6309ae2a7611
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 332820 ms
Total Talk Time (AGENT): 147444 ms
Total Talk Time (CUSTOMER): 73640 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/78fb53b6-b10d-439a-92c0-6309ae2a7611_20250313T15:51_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from Atlantic Dermatology, and I'm trying to see if I can verify benefits for a patient.
[AGENT][POSITIVE] OK, [PII], I'm happy to verify benefits today. Do you have the policy number?
[CUSTOMER][NEUTRAL] I do. I have 3 032688478.
[AGENT][NEUTRAL] Pull this up here.
[CUSTOMER][NEUTRAL] You know, now that I look at that, that might be her social, um, excuse me.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] I was gonna say I think it's wrong.
[CUSTOMER][NEUTRAL] Yeah, I, I think she said that there wasn't or she couldn't find a policy number, so she gave us her social.
[AGENT][NEUTRAL] OK, let me try that. [PII].
[AGENT][NEUTRAL] All right. And then [PII], what is the patient's first and last name?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] And we're looking for medical coverage, correct? Not dental?
[CUSTOMER][POSITIVE] Correct, yes.
[AGENT][NEUTRAL] OK. And then what is [PII]'s date of birth?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] All right. So the patient does have an active plan with us. The effective date is [PII]. Do you need their policy number?
[CUSTOMER][NEUTRAL] Yes, if you could give that to me.
[AGENT][NEUTRAL] Yeah, absolutely. So policy number is going to be 02.
[AGENT][NEUTRAL] 048061.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] And what kind of um benefits does she have?
[AGENT][NEUTRAL] So this is a limited benefit like a hospital indemnity plan. Is she being seen for like an office visit or?
[CUSTOMER][NEUTRAL] Yes, office visits.
[AGENT][NEUTRAL] OK, so let's see.
[AGENT][NEUTRAL] Patient is allowed, it looks like a maximum of 5 visits per year.
[AGENT][NEUTRAL] And it looks like the plan pays a benefit amount of $75 towards the visit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Now, if she has any type of um procedures done in the office, do those count towards the office visit towards the $75?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] So, the only other benefits that are separate would be like um diagnostic testing um or like a wellness exam. Those are the only other things, yeah, that I show is like additional benefits. Um it does have a surgical benefit, but let me see.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So, the plan does have like a surgical benefit up to $2000 it looks like that's the max.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] Um, and do you have an address for claims?
[AGENT][POSITIVE] Yeah, let me grab that for you. Give me one second here.
[AGENT][NEUTRAL] All right, so it looks like for claims on this plan, they're going to um it's attention IMA Inc.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that's at [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that's in [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm. And there is also a payer ID if you want that.
[CUSTOMER][POSITIVE] Oh yep absolutely.
[AGENT][NEUTRAL] Payer ID is 64556.
[CUSTOMER][NEUTRAL] That's what we have.
[CUSTOMER][NEUTRAL] OK, that is all I need.
[AGENT][POSITIVE] Alright, sounds good well thanks for calling APL. I hope you have a good rest of your day, [PII].
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][NEUTRAL] Mhm bye bye.