AccountId: 011433970860
ContactId: 863652a3-54a4-4364-afda-b67928af2010
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 137509 ms
Total Talk Time (AGENT): 75638 ms
Total Talk Time (CUSTOMER): 52685 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/863652a3-54a4-4364-afda-b67928af2010_20250110T15:58_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII]. I'm calling from the physician office to verify patients benefits.
[AGENT][POSITIVE] OK, sure, I can assist you with that. This is [PII]. May I have a call back number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure it's [PII].
[AGENT][NEUTRAL] Thank you and may I have the patient's policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] Policy number is 02203102ML8.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] as [PII] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And you say you need benefits and what type of service is being render for benefits?
[CUSTOMER][NEUTRAL] Uh, um, every specialist offices like trasound done in office or or you got proceeded on in office, and if she has in patients benefits as well, how much would be her much.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. All right. And before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. And this is one of our secondary supplemental plans to the major medical.
[AGENT][NEUTRAL] Um, with this one, we have an outpatient maximum of 7900 per covered person per calendar year. This includes procedures or treatments done in the office. It does not include the office visits, so the office visit is not covered. It's just for procedures or treatments. Um, and then you have an inpatient of 7900.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] OK, so for outpatient 7900 and same amount for a patient, right?
[AGENT][NEUTRAL] Inpatient. Correct, yes. Mhm.
[CUSTOMER][NEUTRAL] And office this is a call for.
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK, great, perfect, thank you so much. So, um, that will be um the reference number is gonna be your name on this day or you can generate one. OK, perfect. Thank you so much and have a wonderful weekend.
[AGENT][NEUTRAL] You work
[AGENT][POSITIVE] That is correct, yes.
[AGENT][POSITIVE] Yes, exactly.
[AGENT][POSITIVE] You as well, and thank you for calling ATL. Have a good day. You're welcome. Bye bye.
[CUSTOMER][POSITIVE] Thank you bye bye.