AccountId: 011433970860
ContactId: 869b6a24-60a4-419d-afe2-3ae125abda1f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 345130 ms
Total Talk Time (AGENT): 145104 ms
Total Talk Time (CUSTOMER): 155214 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/07/869b6a24-60a4-419d-afe2-3ae125abda1f_20250507T20:31_UTC.wav
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[AGENT][POSITIVE] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, did you say [PII]?
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][POSITIVE] Oh, [PII], hi, good afternoon, [PII], how are you? I do apologize for that.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] That's fine.
[AGENT][POSITIVE] That's fine, no problem at all.
[CUSTOMER][NEUTRAL] Um, and Ms. [PII], may I please have the first initial of your last name?
[AGENT][NEUTRAL] It would be A.
[CUSTOMER][POSITIVE] Wonderful, thank you. Uh my name is [PII]. If you need me to spell it, I will, which is [PII]
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] And the first initial of my last name is [PII]
[AGENT][POSITIVE] Thank you Ms. [PII]. And then what is your callback number, ma'am? Just in case the call is dropped I can call you right back.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you, ma'am. And how can I help you today?
[CUSTOMER][NEGATIVE] No thank you.
[CUSTOMER][NEUTRAL] Yeah, I'm looking for um outpatient benefits on a mutual um client or patient or insured insured is the word because they're not a patient but they're the insured I was trying to make it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am. I, yes, I can help you with the benefits. And what is the, um, the patient's name, date of birth, and policy number?
[CUSTOMER][POSITIVE] Wonderful.
[CUSTOMER][NEUTRAL] OK, let me go ahead and give you that, um, let's see.
[CUSTOMER][NEUTRAL] OK. Policy number is 241-9356.
[CUSTOMER][NEUTRAL] And her first name is [PII], [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, let me look up that policy real quick.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] She's gonna be doing the X-ray of the lumbard.
[AGENT][NEUTRAL] OK, and I do show that Ms. [PII]'s policy is no longer active. This policy terminated on [PII], but I'm checking, um, she does have another policy. Yes, that is active. Let me give you that policy number.
[CUSTOMER][NEUTRAL] Maybe she has another one.
[CUSTOMER][NEUTRAL] OK, let me then go ahead and delete this one. Go ahead with that new one please and thank you.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] It's 2, you're very welcome. It's 255-6460.
[CUSTOMER][NEUTRAL] 255
[CUSTOMER][NEUTRAL] 6460. OK. So it's 25 56 460.
[AGENT][NEUTRAL] Yes ma'am, and the policy effective date.
[CUSTOMER][NEUTRAL] OK, and does it have the same?
[AGENT][NEUTRAL] Yeah, go ahead.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Does it have the same group number 24399?
[AGENT][NEUTRAL] No ma'am, let me give you the group number.
[CUSTOMER][NEUTRAL] OK, go ahead with that.
[AGENT][NEUTRAL] It's 80094.
[AGENT][NEUTRAL] Sunshine gasoline distributors.
[CUSTOMER][NEUTRAL] OK, so 80.
[CUSTOMER][NEUTRAL] Yep, that's the same uh stays the same, OK.
[CUSTOMER][POSITIVE] So you were saying before that? I'm so sorry.
[AGENT][NEUTRAL] It's OK. Um, the effective date of the policy is [PII].
[AGENT][NEUTRAL] And this is just to verify her benefits. It's not a guarantee of payment. This is a supplemental insurance policy that's billed secondary to the primary.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] She has an inpatient benefit amount per calendar year of $8700 and then she also has an outpatient calendar year benefit of $8700 and it helps with deductible, co-pay or co-insurance.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Correct, has she used any so far this year? or uh through last year as well because it started in October of last year, mhm.
[AGENT][NEUTRAL] Let me check
[AGENT][NEUTRAL] Right, she gets new benefits annually, so we'll look from [PII] to present.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] It's gonna be just a second while I pull that in.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] She has only used $12.14 this year.
[CUSTOMER][NEUTRAL] Oh well.
[AGENT][NEUTRAL] Yeah, she still has a bunch left.
[CUSTOMER][NEUTRAL] OK, so she's still, yes.
[CUSTOMER][NEUTRAL] OK, wonderful. OK, can I go ahead and use your first name, um, your last name, and today's date as a reference number?
[AGENT][POSITIVE] Yes, ma'am, you can.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] So I'm gonna use query.
[CUSTOMER][NEUTRAL] And I'm on another field. I have to come back to the other. What what was your first initial of your last name? I do apologize.
[AGENT][NEUTRAL] It's A
[CUSTOMER][POSITIVE] A wonderful that you did say that. OK, so [PII].
[CUSTOMER][NEUTRAL] OK, thank you. um, anything else that you need from me?
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] You're very
[AGENT][NEUTRAL] No, ma'am. Is there anything you need from me, Ms. [PII]?
[CUSTOMER][POSITIVE] No, no, Ms. [PII]. Thank you so much and you have a great afternoon.
[AGENT][NEUTRAL] Uh
[AGENT][POSITIVE] You too and thank you for calling APL. Bye-bye.
[CUSTOMER][POSITIVE] Take care.
[CUSTOMER][POSITIVE] OK take care bye bye.