AccountId: 011433970860
ContactId: 82e5cb4f-93af-463b-b216-07c2f54fecaa
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 173559 ms
Total Talk Time (AGENT): 102318 ms
Total Talk Time (CUSTOMER): 48936 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/82e5cb4f-93af-463b-b216-07c2f54fecaa_20250523T13:19_UTC.wav
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[AGENT][POSITIVE] Thank you for contacting ATL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, I am needing to check patients benefits, um, and to see if he has any medical coverage.
[AGENT][POSITIVE] Yes, I can certainly help with benefits with whom am I help uh with whom am I speaking?
[CUSTOMER][NEUTRAL] Um, it's [PII] last initials [PII]. It's kind of hard to hear you, sorry.
[AGENT][NEUTRAL] Yeah, [PII], I'm sorry, I'm having a little trouble with my phone. Um, what is that policy number, please, that we're looking at?
[CUSTOMER][NEUTRAL] It is 01835971.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] It is [PII] [PII].
[AGENT][POSITIVE] I do appreciate that. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, it's [PII]. That's a direct line.
[AGENT][NEUTRAL] Thank you. This policy went into effect on [PII]. It is active. Now, this policy has in and out of hospital benefits, um, and, and this is for, uh, inpatient hospital or outpatient hospital only.
[AGENT][NEUTRAL] And so what we will do
[CUSTOMER][NEUTRAL] It'll be outpatient
[AGENT][NEUTRAL] Oh, is it? No, that's, that's fine. Um, for outpatient hospital, we will pick up the deductibles, co-payment, or co-insurance up to $1500 per calendar year. That's just the verification of those benefits, not a guarantee of payment. [PII] has not used any of these benefits for this current year, so they're all available.
[CUSTOMER][NEUTRAL] Oh sorry go ahead.
[AGENT][NEUTRAL] Is there anything else, [PII], I can tell you about the policy while we're on the phone?
[CUSTOMER][NEUTRAL] Yes, am I able to check to see if an authorizations required for him?
[AGENT][NEUTRAL] Well, it's, it's not, uh, we're not gonna require an authorization because we're a secondary insurance. So as long as you're in, uh, network with his primary and there's a deductible, co-payment or co-insurance, then we're good.
[AGENT][NEUTRAL] Now, this policy is for sickness or accidents, so if it's cosmetic surgery, then, then we're not gonna, you know, be able to help with that. But otherwise, um, there's no pre-op that is uh required to use.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, so for like a wrist fracture you guys would cover whatever Blue Cross does not pick up, is that correct?
[AGENT][NEUTRAL] That is correct, yes, up to that, up to that, uh, $1500 maximum.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Did you
[CUSTOMER][NEUTRAL] Oh, you just, you would pay up to 1500, right?
[AGENT][POSITIVE] That's correct, yes, yes.
[CUSTOMER][NEUTRAL] OK, all right, and um could I get a good reference number please?
[AGENT][NEUTRAL] Yes, my name is [PII], and the first letter of my last name is [PII].
[AGENT][NEUTRAL] And we're gonna use that in today's date as our reference. Now, is there anything else at all that I can help with? Would you like to know where to send your claims, anything at all?
[CUSTOMER][NEUTRAL] Nope, that'll be it.
[AGENT][POSITIVE] OK, well, thank you for contacting ATL. very good.