AccountId: 011433970860
ContactId: 854d9c21-580e-4dd0-af26-7f59433cdac4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 203520 ms
Total Talk Time (AGENT): 129149 ms
Total Talk Time (CUSTOMER): 61772 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/854d9c21-580e-4dd0-af26-7f59433cdac4_20250509T17:44_UTC.wav
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[AGENT][POSITIVE] Thank you for contacting A. My name is [PII]. How may I.
[CUSTOMER][NEUTRAL] Uh, hi, my name is [PII]. I'm so sorry you sound really muffled and far away, so I did not catch your name.
[AGENT][NEUTRAL] Yeah, I'm sorry. My name is [PII]. I'm with ATL. How may I help you?
[CUSTOMER][NEUTRAL] I'm calling to verify benefits for a patient or rather to verify that this says they're secondary and whether or not it's gonna cover any primary um co-insurance.
[AGENT][NEUTRAL] Yes, I can, I can certainly look at benefits. [PII], what's that policy number?
[CUSTOMER][NEUTRAL] It's 01445050 M as in Mary, L as in Lima 8.
[AGENT][NEUTRAL] Thank you. And is there um and the insured's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII] or [PII], date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] Of course [PII].
[AGENT][POSITIVE] I do appreciate that. Thank you very much. I'm looking at this policy now.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Um, now, you mentioned eligibility. Let's now this is a secondary or gap insurance. It's just to pick up the deductible, co-payment or co-insurance from his major medical.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And whenever they, this is a group insurance [PII] employer and whenever they renew as a group.
[AGENT][NEUTRAL] They get a new policy number. So there's a new policy number which went into effect on [PII] and which is active.
[AGENT][NEUTRAL] It's 02
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 467.
[AGENT][NEUTRAL] 420. Let me just repeat that again because I know my phone's kind of messing up 02.
[CUSTOMER][NEUTRAL] I got you, uh huh.
[AGENT][NEUTRAL] 467-420 that went into effect on [PII]. It is active. Now the policy, um, uh,
[AGENT][NEUTRAL] The benefits are for in and out of hospital settings, um, uh, treatment within a physician's office. So is there anything in particular that we need to look at?
[CUSTOMER][NEUTRAL] 47.
[CUSTOMER][NEUTRAL] For physical therapy, outpatient physical therapy in an office setting.
[AGENT][NEUTRAL] Yes, certainly. So what we will do is we will pick up the deductible, co-payment of coinsurance from his major medical.
[AGENT][NEUTRAL] Up to $5000 per calendar year for that type of service. Now that's just a verification of the benefits, not a guarantee of payment, but that is what this policy is meant to do. And let me just check here and see um how much of this you do for the calendar year [PII].
[AGENT][NEUTRAL] 25, so it looks like he's used approximately $220 of that $5000. So, uh, again that, that is just a verification, not a guarantee of payment, but [PII], that's what this policy will do I'll file through the major medical first and then through uh.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Now, is there anything else, uh, would you like to know how to submit a claim or is there anything else at all that I may help with?
[CUSTOMER][POSITIVE] Uh, no, actually that's, that pretty much answers my question. If I could get a reference number for our call, please?
[AGENT][NEUTRAL] Yes, my name is [PII], and the first letter of my last name is [PII], and we'll use that in today's date, the [PII] as our verification.
[CUSTOMER][POSITIVE] Perfect I appreciate your time and patience. I hope you have a great rest of your day.
[AGENT][POSITIVE] Well, thank you for contacting ATL.