AccountId: 011433970860
ContactId: 8ff5e3b9-04ae-4016-bebf-2971d4c2cc4f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 190309 ms
Total Talk Time (AGENT): 85498 ms
Total Talk Time (CUSTOMER): 45377 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/8ff5e3b9-04ae-4016-bebf-2971d4c2cc4f_20250103T20:29_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from Advanced Orthopedics of Oklahoma. I need to verify patients' eligibility and benefits.
[AGENT][NEUTRAL] OK, yeah, I can check eligibility benefits for you. Uh, [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, thank you and then do you have the policy number?
[CUSTOMER][NEUTRAL] I do, um, it's 01780461.
[AGENT][NEUTRAL] OK, thank you. And uh what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] And it's for [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, perfect. Thank you for verifying that [PII]. Uh, so the policy is active. Effective date was [PII].
[AGENT][NEUTRAL] And this is a secondary medical policy, that it is designed to help with co-pay, deductible and co-insurance after major medical pays.
[AGENT][NEUTRAL] Uh, where we need to look at outpatient benefits?
[CUSTOMER][NEUTRAL] Uh yes.
[AGENT][NEUTRAL] OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims. So the outpatient benefit is $2500 max per calendar year. I don't imagine any has been used yet, but I will still go ahead and check. Give me just a moment.
[AGENT][NEUTRAL] OK, no, nothing has been used so far this year.
[CUSTOMER][NEUTRAL] OK, and then there's also for a specialist office visit, is the co-pay covered um with you guys or just the patient subject to that?
[AGENT][NEUTRAL] Um, let me verify. Give me just a moment. Not all of our, uh, secondary medical policies cover office visits. Um, so let me see if that's covered under this policy. Bear with me just a moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] The office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, alright, well that is all I was needing for today then. Um, can I have a reference number for our call?
[AGENT][NEUTRAL] Yeah, reference number would just be my first name, last initial, and today's date. Uh so my name is spelled [PII] And was there anything else I could help you with, [PII]?
[CUSTOMER][POSITIVE] No, that'll be all thank you so much.
[AGENT][POSITIVE] Alright, yeah, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] You too thank you bye bye.
[AGENT][POSITIVE] Thank you. Bye bye.