AccountId: 011433970860
ContactId: 8058f0a8-c29f-487b-ad29-2b13053a1d01
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 464720 ms
Total Talk Time (AGENT): 138167 ms
Total Talk Time (CUSTOMER): 91211 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/8058f0a8-c29f-487b-ad29-2b13053a1d01_20250219T15:51_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from Tara and Care Center to verify um benefits and eligibility for a patient.
[AGENT][NEUTRAL] OK Ms. [PII], I can help you with benefits and eligibility um may I please get your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Thank you. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] name.
[CUSTOMER][NEUTRAL] [PII], uh, [PII] and policy number is 02507358.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm gonna pull that policy up real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, I, I do show that [PII] does have an active policy with us and the effective date is [PII].
[AGENT][NEUTRAL] And this is just to verify benefits, it's not a guarantee of payment.
[AGENT][NEUTRAL] He has a limited hospital indemnity plan.
[AGENT][NEUTRAL] That helps if he is admitted to the hospital, he has an admission benefit one day per calendar year of $500.
[AGENT][NEUTRAL] And then if he's confined in the hospital for 18 hours or more, he has 30 days per calendar year that pays $50.
[AGENT][NEUTRAL] He can visit a physician's office, ER or urgent care center.
[AGENT][NEUTRAL] Um, he has 4 visits per year that pay $50.
[CUSTOMER][NEUTRAL] So that's like an office visit. He has 4.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] For per calendar year.
[CUSTOMER][NEUTRAL] OK, and then this, OK, so this plan would only cover offices. There's nothing for like physical therapy or medical injections or anything like that?
[AGENT][NEUTRAL] He has a physical therapy benefit that pays $30.
[AGENT][NEUTRAL] And it's for
[CUSTOMER][NEUTRAL] Per visit?
[AGENT][NEUTRAL] Uh, he gets 4 per calendar year.
[AGENT][NEUTRAL] And then this is, um, all of his visits are for accident or sickness.
[CUSTOMER][NEUTRAL] That's a stiffness. And then is there a benefit for um chiropractic and acupuncture?
[AGENT][NEUTRAL] Mm, let me pull up his policy and read and see if those are listed in it at all.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] It's gonna be just a moment while the computer loads it and let me read through it.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I haven't seen anything yet, but I'm still looking.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I don't see anything that covers chiropractic or um acupuncture.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[AGENT][POSITIVE] I do see that he has a prescription benefit, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see, $10 per day, a maximum of 15 days per calendar year.
[CUSTOMER][NEUTRAL] OK, and do.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Is any durable medical equipment is that?
[AGENT][NEUTRAL] Uh let me see, let me check for that.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEGATIVE] No, I do not see durable medical equipment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So just the office visits and then the for physical therapy as well.
[CUSTOMER][NEUTRAL] Under this plan?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, OK, alright, well, oh, is there an out of pocket or deductible?
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Let me check.
[AGENT][NEUTRAL] I do not see a deductible or out of pocket.
[CUSTOMER][NEUTRAL] OK, alright, um, that is all I needed uh could I please have a reference number for our call?
[AGENT][NEUTRAL] Yes, ma'am, you can use my name [PII] in today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you again for your time.
[AGENT][POSITIVE] You're very welcome, Miss [PII]. Thanks for calling APL and I hope you have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.