AccountId: 011433970860
ContactId: 90659518-7318-467e-8ad3-6156a2782e35
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 224520 ms
Total Talk Time (AGENT): 104704 ms
Total Talk Time (CUSTOMER): 120919 ms
Interruptions: 5
Overall Sentiment: AGENT=1.8, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/30/90659518-7318-467e-8ad3-6156a2782e35_20250530T15:10_UTC.wav
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[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm just calling on behalf of a mutual patient and um this patient's gonna be going in for their procedure. They gave me this insurance as a secondary, so I wanted to verify what his benefits are.
[AGENT][POSITIVE] OK, I can help you with the benefits for this patient. May I please get your name and your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah, that one
[CUSTOMER][NEUTRAL] Yes, it's [PII] and my call back number that's gonna be [PII]. I do have an extension. It's [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So you can continue with the with the next few and then.
[AGENT][NEUTRAL] OK, thank you, Ms. [PII]. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So name is [PII]. Date of birth is [PII].
[CUSTOMER][NEUTRAL] And then that policy number is gonna be 0199.
[CUSTOMER][NEUTRAL] 1307 M as in Mike L as in Larry, the number 8.
[AGENT][NEUTRAL] Thank you, and then may I please have the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, so our office is called Gastro Health.
[AGENT][POSITIVE] Alright, thank you so much. Let me look up that policy real quick.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] I do show that [PII] does have an active policy. His effective date is [PII].
[CUSTOMER][NEUTRAL] Really
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Hi
[AGENT][NEUTRAL] And this is just to verify benefits. It's not a guarantee of payment. You are correct that it is a supplemental insurance that's billed secondary to the primary. It helps with deductible, co-pay and co-insurance. He has an inpatient per occurrence benefit amount of $500.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And he also has an outpatient per occurrence of $500.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, and these benefits, um, they're kind of first come, first serve, um, because I'm since I'm calling from the doctor's office, I know the facility is also gonna charge so that $500 is whoever gets it first, correct?
[AGENT][NEUTRAL] Correct. Would you like for me to see if he has anything left for the year?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] Since you mentioned that, OK, and this is like I said, just to verify benefits, it's not a guarantee of payment. He has used only $108.35 of his inpatient benefit.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Correct, yes.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, and what about outpatient?
[AGENT][NEUTRAL] Nothing has been used for outpatient.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alrighty, um, and that really is all the information I am looking for.
[CUSTOMER][NEUTRAL] Um, is there a reference number for this call?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes ma'am, you can use my name [PII] and today's date.
[CUSTOMER][POSITIVE] OK, thank you so much [PII].
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. Thank you for calling APL. I hope you have a wonderful weekend.
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][POSITIVE] You're welcome. Bye-bye.
[CUSTOMER][NEUTRAL] OK