AccountId: 011433970860
ContactId: 82ee6b48-c9e2-4c28-b763-2c1749e56056
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 221729 ms
Total Talk Time (AGENT): 90017 ms
Total Talk Time (CUSTOMER): 69179 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/82ee6b48-c9e2-4c28-b763-2c1749e56056_20250505T13:49_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. I'm calling from urology specialty care calling to verify benefits for a patient.
[AGENT][POSITIVE] Alright, I'm happy to check benefits. What's the policy number?
[CUSTOMER][NEUTRAL] It is 0202509920 ML 8.
[AGENT][NEUTRAL] All right, thank you for that. And then for documentation, can I get your first name, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII]. What's the patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII], date of birth [PII].
[AGENT][NEUTRAL] Thank you. So, patient is active. Effective date is [PII]. We're the member of secondary insurance, so this will cover deductible, co-pay, co-insurance, the primary does not.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, you said deductible and copay?
[AGENT][NEUTRAL] And co-insurance. Yes, ma'am.
[CUSTOMER][NEUTRAL] And coinsurance, give me one second to document that.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So he's covered at 100%?
[AGENT][NEUTRAL] Yeah. Is the patient coming in? Is, are you looking for like the office visit fee to be covered? That's the only thing sometimes that is not.
[CUSTOMER][NEUTRAL] OK, yes, I do, uh, that's the copay.
[AGENT][NEUTRAL] OK. So let me see if the member's plan does cover that or if it's just treatment. Give me just one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, so patients plan is not gonna cover the physician's office visit fee, um, that's not included.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So it's just treatment in a physician's office.
[CUSTOMER][NEUTRAL] Do they have a maximum for treatments?
[AGENT][NEUTRAL] Yeah, let me take a look. So it'd fall under outpatient benefits and their benefit max on here is per calendar day and that's $750 per day.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I would need to call the same day of his appointment to verify.
[CUSTOMER][NEUTRAL] How much if he's used anything?
[AGENT][POSITIVE] Yeah, you can always double check with us to see if anything's used for the day absolutely.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] May I have your name and a reference number please?
[AGENT][NEUTRAL] Absolutely. Call reference is my name with my last initial, then today's date. My name again is [PII], that's [PII] last [PII] is [PII], and then today's date.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] All right.
[CUSTOMER][POSITIVE] Thank you very much you have a wonderful day.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] You too. Bye.