AccountId: 011433970860
ContactId: 92b8b41e-e9d6-4304-a5a6-235731c9d80f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 176160 ms
Total Talk Time (AGENT): 80162 ms
Total Talk Time (CUSTOMER): 62067 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/92b8b41e-e9d6-4304-a5a6-235731c9d80f_20250624T13:55_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, I'm calling. Um, verify benefits for a member just to see regarding what benefits a member has in this plan.
[AGENT][POSITIVE] Um, yes, ma'am. I can assist you with benefits. Um, first, I need your name and a good callback number.
[CUSTOMER][NEUTRAL] My name's [PII]. Callback number is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] 02640204
[AGENT][NEUTRAL] Thank you. And now please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And date of birth, give me one moment.
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] OK, and just submit advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII]. The policy is still active.
[CUSTOMER][NEUTRAL] Just
[AGENT][NEUTRAL] And um what do you, what do you need to verify, inpatient, outpatient, or office visits?
[CUSTOMER][NEUTRAL] So the, yeah, office visit, so the patient has other insurance and he has a copay, so he said that since he has this insurance, he does not need to pay the copay, so we need to verify if that is correct that you guys cover the copay.
[AGENT][NEUTRAL] Well, not for office visits. We don't cover the co-pay, but what we do cover for office visits, um, we cover the co-insurance and the deductible after the primary insurance processes the claim and we cover that up to 4000 per calendar year. But for office visits, the co-pay is not covered.
[CUSTOMER][NEUTRAL] OK, so that would still apply towards him.
[AGENT][POSITIVE] Yes, ma'am. That's correct.
[CUSTOMER][NEUTRAL] Excuse me, so it, so we would still charge the patient his copay.
[AGENT][NEUTRAL] Yes, ma'am. Yeah, because it's not covered under the secondary, which is um this insurance.
[CUSTOMER][POSITIVE] Perfect. OK. Can I get a reference number?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. My name is [PII]. It's spelled [PII] Last initial is [PII], and today's date. Um, is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] No, that would be it.
[AGENT][POSITIVE] OK. Well, I thank you, [PII], for calling APL. You have a great day. Mm bye.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Hm, thank you.