AccountId: 011433970860
ContactId: 91855ecd-5ef2-47a2-8727-6e444f7f25e6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 241419 ms
Total Talk Time (AGENT): 115388 ms
Total Talk Time (CUSTOMER): 94985 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/91855ecd-5ef2-47a2-8727-6e444f7f25e6_20250516T15:32_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good, good morning, miss. I'm calling for a professional office. Um, I need to verify the benefit for one more patient.
[AGENT][NEUTRAL] OK, I can check those benefits for you. Uh, what was your name please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK and then can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] What do you need?
[AGENT][POSITIVE] A good call back number in case we're disconnected please?
[CUSTOMER][NEUTRAL] Oh, yes, it's [PII].
[AGENT][NEUTRAL] OK, thank you and then do you have the policy number?
[CUSTOMER][NEUTRAL] The policy number that I have is 22717.
[AGENT][NEUTRAL] OK, that's going to be a bit too small to be one of our policy numbers. Um, do you maybe have their social?
[CUSTOMER][NEUTRAL] Let me see if I have them.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] The social, oh, I'm sorry, I have one here. I have um [PII].
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, and what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] Her name is [PII]. Her date of birth is [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that. Uh, so this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays. And are we needing to check uh inpatient or outpatient benefits for this number?
[CUSTOMER][NEUTRAL] Um, I'm calling for a professional, uh, billing for outpatient surgery.
[AGENT][NEUTRAL] Outpatient, OK, so of course I will let you know verification of coverage is not a guarantee of payment for claims. Their outpatient benefit is $2500 per calendar year. If you'll give me one moment, I will see if any of that has been used.
[CUSTOMER][POSITIVE] Yes, thank you.
[AGENT][NEUTRAL] OK, so none has been used so far this year.
[CUSTOMER][NEUTRAL] So she still have the 2, 1500, right?
[AGENT][POSITIVE] She has the full benefit. Correct.
[CUSTOMER][NEUTRAL] The full benefit. OK, that is for outpatient of um for facility and for the office is the same thing?
[AGENT][NEUTRAL] It's all the outpatient benefit is under that same bucket, so they have a separate benefit for inpatient, um, but anything for outpatient would fall under that $2500 benefit.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK, and can you provide me the one for inpatient too, please?
[AGENT][NEUTRAL] Sure, that inpatient benefit is $4000 max per calendar year.
[CUSTOMER][NEUTRAL] 4, 4000?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Only 4000.
[AGENT][NEUTRAL] 4000 for inpatient benefits, yes.
[CUSTOMER][NEUTRAL] OK, benefit. OK, [PII], thank you so much. Um, I think that's all. Uh, can you provide me a reference number for this call?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure, that would just be my first name, last initial, and today's date. Uh, so my name is spelled [PII]
[CUSTOMER][NEUTRAL] I'm sorry, the line is cut off.
[AGENT][NEUTRAL] Oh, I'm sorry, uh, reference number would be my first name, last initial, and today's date. My name is spelled [PII] and there wasn't anything else I could help you with?
[CUSTOMER][POSITIVE] No, that's all. Thank you so much. I really appreciate. Have a wonderful day.
[AGENT][POSITIVE] Of course, thanks for your account. You too, bye bye.
[CUSTOMER][POSITIVE] Thank you. Bye.
[AGENT][NEUTRAL] Bye bye.