AccountId: 011433970860
ContactId: 8e46f9a6-8f71-48f0-8851-3e9ab5b9c469
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 172860 ms
Total Talk Time (AGENT): 93900 ms
Total Talk Time (CUSTOMER): 54120 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/8e46f9a6-8f71-48f0-8851-3e9ab5b9c469_20250109T21:09_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling to verify benefits please.
[AGENT][POSITIVE] OK, sure, I can assist you with benefits, Miss [PII]. May I have a callback number just in case we get disconnected? You're welcome.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yes, yes, [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you. What's the patient's policy number?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] It is 02518870.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Alright, and what's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] It's [PII] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Alright, and Miss [PII], what type of service is being rendered for benefits?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] It's for office services. I have, I don't know if you work based off CPT codes, but there are ultrasounds to be done in our office.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. OK. That's good enough. 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. Um, with this one, we cover office treatments. We do not cover office visits. Um, the office treatments or procedures are subject to the outpatient maximum which is $300 per day.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][NEUTRAL] Um, so it's an outpatient 300 per day.
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK wonderful what are there any inpatient um.
[CUSTOMER][NEUTRAL] Benefits
[AGENT][NEUTRAL] Yes, yes, let me go ahead and get that for you, um, one moment.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Let me make sure that you get our paper.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][POSITIVE] All right, for the inpatient, we have a benefit of
[AGENT][NEUTRAL] 1650.
[CUSTOMER][NEUTRAL] Is that per day or per year?
[AGENT][NEUTRAL] That is um inpatient Max um.
[AGENT][NEUTRAL] Let me just check something really really quick.
[AGENT][NEUTRAL] For all covered person that's combined and maximum for yeah, that is the maximum benefit per calendar year is 1650.
[CUSTOMER][NEUTRAL] 1650 per year, perfect. OK and is there a reference number for this call?
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will. Do you need the spelling of my name or any other information?
[CUSTOMER][POSITIVE] Nope, that'll be all thank you.
[AGENT][POSITIVE] You're welcome and thank you for calling ATO. Have a good day, Miss [PII].
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank