AccountId: 011433970860
ContactId: 88a60615-646d-4c3c-9c28-79aece5fc5b3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 229619 ms
Total Talk Time (AGENT): 103642 ms
Total Talk Time (CUSTOMER): 74578 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=2.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/30/88a60615-646d-4c3c-9c28-79aece5fc5b3_20250430T19:49_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is uh [PII] calling from Nicholas Children's Hospital. And I'm here to check the patient's eligibility and benefits.
[AGENT][NEUTRAL] OK, [PII], you're needing eligibility and benefits for one member, is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that. And what is your callback number, please, [PII]?
[CUSTOMER][NEUTRAL] [PII]. And the extension would be [PII].
[AGENT][NEUTRAL] [PII]. And what was the last number?
[CUSTOMER][NEUTRAL] 5
[AGENT][NEUTRAL] [PII]. OK, thank you. And the member's policy number, please.
[CUSTOMER][POSITIVE] Yes, I'll provide you that.
[CUSTOMER][NEUTRAL] That would be 1988283.
[CUSTOMER][NEUTRAL] M as in Mike, L as in Lima, and the last digit is the number 8.
[AGENT][NEUTRAL] OK, thank you [PII] one moment while I get the member's information pulled up please.
[CUSTOMER][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] And [PII], any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] The patient's first name is [PII].
[CUSTOMER][NEUTRAL] And the last name is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so this, he is a dependent on this supplemental policy and it is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what type of benefit information do you need from him, [PII], inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yeah, I would like to get the specialist office visit for a network individual.
[AGENT][NEUTRAL] OK, so there is no network affiliated with this policy because this is a supplemental policy, so it would follow their primary insurance.
[AGENT][NEUTRAL] And let me see, you said for an office visit?
[CUSTOMER][NEUTRAL] Could you please come again.
[CUSTOMER][POSITIVE] Yeah. Could you please come again the effective day?
[AGENT][NEUTRAL] Pardon me?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, so um
[CUSTOMER][NEUTRAL] Could you please tell me your name?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] And my name in today's date will also be your call reference number.
[AGENT][NEUTRAL] Now, the supplemental policy, [PII] does not cover office visits.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][POSITIVE] Thank you. Um,
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] So, for the confirmation, no other benefits.
[CUSTOMER][NEUTRAL] Or um
[CUSTOMER][NEUTRAL] Cannot be applicable to this um secondary, right?
[AGENT][NEUTRAL] For an office visit?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] Office visits are not covered.
[CUSTOMER][POSITIVE] Thank you. Thank you so much, [PII], for assistance.
[AGENT][POSITIVE] Yes, ma'am. Yeah. You're very welcome. And is there anything else?
[CUSTOMER][POSITIVE] And how wonderful
[CUSTOMER][POSITIVE] No, that's for the, thank you.
[AGENT][POSITIVE] OK, [PII]. Well then, thank you for calling APL and I hope that you have a very nice rest of your day.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Bye-bye.