AccountId: 011433970860
ContactId: 89dfebe2-67b6-489d-84a0-d0c8d4a0e65a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 161419 ms
Total Talk Time (AGENT): 71983 ms
Total Talk Time (CUSTOMER): 82645 ms
Interruptions: 2
Overall Sentiment: AGENT=1.5, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/13/89dfebe2-67b6-489d-84a0-d0c8d4a0e65a_20250613T13:41_UTC.wav
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[CUSTOMER][NEUTRAL] Is this right?
[AGENT][POSITIVE] Thanks for calling ETM. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good morning, um, I'm calling from provider's office to verify benefits.
[AGENT][POSITIVE] Yes, ma'am. I can assist you with benefits. Um, first, I'll need a good callback number just in case we're disconnected.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK. And could I get your name, please?
[CUSTOMER][NEUTRAL] Um, my name is [PII]
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now, could I get the policy number?
[CUSTOMER][NEUTRAL] Yes, it is 02496788.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] date of birth is [PII].
[AGENT][NEUTRAL] Thank you and just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII]. The policy is still active. And is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Uh, this will be for outpatient hospital.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] For outpatient services, we cover up to 4000 per calendar year and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim.
[CUSTOMER][NEUTRAL] They could pay, um, OK, um, has he used any of the $4000.
[AGENT][NEUTRAL] Um, so far, he's used $255.66.
[CUSTOMER][NEUTRAL] 5566. OK, perfect. Um, so just to recollect, he's covered in outpatient services up to 4000. This covered the deductible coinsurance and copay. He has used only 255 with 66 and has been active since [PII].
[AGENT][POSITIVE] Yes, ma'am. That's correct.
[CUSTOMER][POSITIVE] Awesome, perfect, and could do you provide uh reference numbers for the calls?
[AGENT][NEUTRAL] Um, yes, for the reference number, you can use my name and today's date. My name is [PII]. Um, it's spelled [PII] Last initial is [PII], and today's date. Um, is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][POSITIVE] No, that will be all. Thank you for your help. Have a great day [PII]. Thank you, bye bye.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling ATL. Mm bye.