AccountId: 011433970860
ContactId: 92d770c4-e746-45d4-ae15-0abfee42f85c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 265670 ms
Total Talk Time (AGENT): 95089 ms
Total Talk Time (CUSTOMER): 83002 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/92d770c4-e746-45d4-ae15-0abfee42f85c_20250310T12:54_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from a provider's office, and I need to get eligibility and benefits for 2 patients, please.
[AGENT][NEUTRAL] OK, I can help you spell your first name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and you're needing eligibility and benefits?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Is this service in a doctor's office?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, what's the policy number and a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Of course, so the good phone number is [PII], and the policy number is 02474261 M as in Mary, L as in love, 7.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you, one moment, let me pull up the file and then I'll be able to help you.
[CUSTOMER][NEUTRAL] Of course.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] is her second last name and her date of birth is [PII].
[AGENT][NEUTRAL] All right, thank you for that information, uh, [PII]. I'm showing the policy effective date is [PII]. Policy is active at this time.
[CUSTOMER][NEUTRAL] Of course.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] And as far as her benefits service in a physician's office is not covered under this policy.
[CUSTOMER][NEUTRAL] OK, um, does she have an outpatient benefit limit because we also do ultrasounds here in the office and she is currently pregnant, so we would be doing an ultrasound every time she comes in.
[AGENT][NEUTRAL] OK, so we, the policy does not have a treatment writer under this policy either. Uh, there is an outpatient benefit, but it would need to be done in an outpatient facility setting.
[AGENT][NEUTRAL] Versus in a uh specialist office.
[CUSTOMER][NEUTRAL] OK, so only outpatient facility would, would be covered, OK.
[AGENT][NEUTRAL] Right, for under the outpatient benefit under this policy.
[CUSTOMER][NEUTRAL] You got it you got it covered and can I have, um, can I have a reference number for this patient? I do have one last one.
[AGENT][NEUTRAL] Anything else?
[AGENT][NEUTRAL] You'll use my name in today's state as your reference, [PII] First initial last name is [PII].
[CUSTOMER][POSITIVE] Perfect. And 3 1025. OK, ma'am, I do have one last one whenever you're ready.
[AGENT][NEUTRAL] Policy number?
[CUSTOMER][NEUTRAL] 02517183 M as in Mary, L as in love, 8.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Of course.
[AGENT][NEUTRAL] Verify the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Her name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Is it for the same benefit?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, so I'm showing effective date is [PII]. This policy is active at this time.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] 2
[AGENT][NEUTRAL] The uh physician visit fee is not covered, but this policy does have the treatment writer, if there's X-rays or any type of testing, um, that maximum outpatient benefit is up to $750. That's per calendar day.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] And any information provided is verification, not a guarantee of payment. And any other questions I can assist with today?
[CUSTOMER][POSITIVE] No, that's it you were great thank you so much [PII].
[AGENT][POSITIVE] Oh, you're welcome. Thank you for calling ATL. Have a good day.
[CUSTOMER][NEUTRAL] Likewise. Bye-bye.