AccountId: 011433970860
ContactId: 95c38b89-2d26-4831-b480-cef3f35c2168
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 182820 ms
Total Talk Time (AGENT): 78800 ms
Total Talk Time (CUSTOMER): 79378 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/19/95c38b89-2d26-4831-b480-cef3f35c2168_20250519T17:37_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, [PII]. My name is [PII]. I'm calling from a gastroenterologist, [PII], and I'm calling to verify that um a patient has active coverage for secondary um to cover his uh co-payment for his primary.
[AGENT][NEUTRAL] Yes, I can certainly look at uh the eligibility. Maybe what's that policy number we're looking at today?
[CUSTOMER][NEUTRAL] Uh, yes, um, let me see what we have here.
[CUSTOMER][NEUTRAL] I'm looking at the card and it says.
[AGENT][NEUTRAL] Does it say outpatient or inpatient benefits? That's usually, yeah, that's kind of confusing but.
[CUSTOMER][NEUTRAL] Maybe it's on the, oh.
[CUSTOMER][NEUTRAL] Yeah, outpatient benefit number is 02419189 M as in Mike, L as in Lima 8.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII]. The date of birth is [PII].
[AGENT][POSITIVE] I appreciate that. Well I'm looking this up if I could just have a callback number please, the event that we disconnected.
[CUSTOMER][NEUTRAL] Yes, that's [PII].
[AGENT][NEUTRAL] Thank you. The policy went into effect on [PII]. It is active. Now, I, I know that you mentioned the eligibility, uh, [PII], would you like to know about any of the benefits of the secondary policy?
[CUSTOMER][NEUTRAL] Yeah, no, well, right now he's actually in office and so he has a $65 co-payment so I was just making sure that if we ran this secondary that it was gonna cover the $65 copayment.
[AGENT][NEUTRAL] Now it won't cover the copayment. What it will cover is the um treatments within the physician's office.
[AGENT][NEUTRAL] Uh, so the office student copay of $65 is not covered.
[AGENT][NEUTRAL] But, uh, treatment within the physician's office is covered. So if he has anything done within the physician's office, um, labs, uh, any sort of procedures, that is covered at $500 per calendar day. That's just a verification of benefits and a guarantee of payment, but that $65 copay for the office co-pay is not covered.
[CUSTOMER][NEUTRAL] OK. So,
[CUSTOMER][NEUTRAL] So um you guys are secondary for like other services other than office visits? is that what you're saying?
[AGENT][POSITIVE] That's, that's correct, yes.
[CUSTOMER][NEUTRAL] OK, alrighty, yeah, and let me um.
[CUSTOMER][NEUTRAL] Let me get a call reference number for you from you for that.
[AGENT][NEUTRAL] Yes, my name is [PII]. The first letter of my last name is [PII], and we're gonna use that today's date as our reference. Is there anything else at all I can tell you about the secondary or gap insurance?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Uh, no, that'll be it. Thank you.
[AGENT][POSITIVE] OK, well thank you for contacting ATL. Have a good day.