AccountId: 011433970860
ContactId: 92374da6-fe14-4999-9c7e-90dec51bed6f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 142740 ms
Total Talk Time (AGENT): 81660 ms
Total Talk Time (CUSTOMER): 44044 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/23/92374da6-fe14-4999-9c7e-90dec51bed6f_20250623T12:34_UTC.wav
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[AGENT][POSITIVE] Thank you for contacting ATL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm calling from provider's office. I'm here to verify member eligibility and benefits.
[AGENT][NEUTRAL] [PII], I can help with eligibility and benefits. What's that policy number, please?
[CUSTOMER][NEUTRAL] Yes, the policy number is 02611488.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Thank you. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] [PII] direct line.
[AGENT][NEUTRAL] [PII]. OK, thank you. And um the uh policy went into effect on [PII]. It is active.
[AGENT][NEUTRAL] This is a secondary or gap insurance. Is there any particular benefits you mentioned wanting to know about benefits? Is there any particular benefit, [PII], that I can help with inpatient, outpatients, physician's office? Yes.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Will it
[CUSTOMER][NEUTRAL] Will it cover the office visit and diagnostic procedures like X-ray and MRI?
[AGENT][NEUTRAL] OK, so the office visit copay is not covered, but
[AGENT][NEUTRAL] The treatments within the physician's office.
[AGENT][NEUTRAL] I covered up to $6500 per calendar year. That's just a verification of the benefits, not a guarantee of payment. So treatment within the physician's office is covered. The office visit co-pay is not.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else like the
[CUSTOMER][NEUTRAL] OK. And out of
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Yes. Out of 6500, how much is used by the patient?
[AGENT][NEUTRAL] Uh, yes, as of this date, um, the patient has not used any of the benefits at all, so they are all available. Is there anything else I can tell you about the policy? Would you like to know where to submit your claim, or?
[CUSTOMER][NEUTRAL] OK, thank you. That's all for today now. Could you please provide me your name and our call reference number?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, my name is [PII]. The first letter of my last name is [PII]. We use that today's date is our rep.
[CUSTOMER][POSITIVE] OK, [PII]. Thank you.
[AGENT][POSITIVE] Thank you for contacting ATL. Have a very good day. Thank you for.