AccountId: 011433970860
ContactId: 7959ab44-eca1-4865-93a1-95bc822c2c1d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 131399 ms
Total Talk Time (AGENT): 81500 ms
Total Talk Time (CUSTOMER): 40468 ms
Interruptions: 0
Overall Sentiment: AGENT=2.3, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/10/7959ab44-eca1-4865-93a1-95bc822c2c1d_20250210T18:44_UTC.wav
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[AGENT][NEUTRAL] For contacting ATM. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey [PII], my name is [PII]. I'm calling from a provider's office. I'm just calling to find the benefits for one of the patients, please.
[AGENT][POSITIVE] Yeah, I can certainly help with benefits. What is that policy number, please?
[CUSTOMER][NEUTRAL] Sure, let me cover.
[CUSTOMER][NEUTRAL] Um, it's 02486313. M as in Mary, L as in Mary, 7.
[AGENT][NEUTRAL] OK, thank you. So you said 02486313?
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] Great, thank you. And the patient's um date of birth and, and I just need to verify your phone number as well.
[CUSTOMER][NEUTRAL] Sure, her date of birth is [PII] you said our telephone number, right?
[AGENT][POSITIVE] Oh yes, please.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. It looks like the policy went into effect on [PII]. It is active. Now you mentioned benefits. This is a secondary or gap insurance and it's meant to pick up the deductible.
[CUSTOMER][NEUTRAL] It's for secondary.
[AGENT][NEUTRAL] Yes, right. Um, and what we do is we take up the deductible, co-payment or co-insurance for in and out of hospital treatment within a physician's office, cancer treatment, independent lab. So is there anything in particular that I could tell you any particular benefits?
[CUSTOMER][NEUTRAL] OK, what about for um an office visit?
[AGENT][NEUTRAL] Yes, now what we will do for an office visit is we will pick up the uh deductible, co-payment or co-insurance for treatments or procedures within the physician's office up to $4000 per calendar year. That's just a verification of benefits, not a guarantee of payments. Um, the office visit co-pay is not covered. So treatment or procedures within physician's office is covered, but not um that office visit co-pay.
[CUSTOMER][NEUTRAL] Not office, is it OK?
[CUSTOMER][POSITIVE] Alright, perfect. May I please have a reference number for the call?
[AGENT][NEUTRAL] Yes, my name is [PII]. The first [PII], and we're gonna use that in today's date as a reference. Is there anything else at all that I may help with?
[CUSTOMER][POSITIVE] No, thank you so much for your help, my dear. Have a good day.
[AGENT][POSITIVE] OK, thanks for contacting AP have a.