AccountId: 011433970860
ContactId: 97f101cd-6b71-48b1-a582-1b7fe96e242f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 185839 ms
Total Talk Time (AGENT): 98698 ms
Total Talk Time (CUSTOMER): 62077 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/97f101cd-6b71-48b1-a582-1b7fe96e242f_20250206T18:27_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, yes, I was calling to verify benefits for a patient.
[AGENT][POSITIVE] Sure, I can assist you with benefits. May I have your name?
[CUSTOMER][NEUTRAL] Hey
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Miss [PII], may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yes, it'll be [PII].
[AGENT][NEUTRAL] And where are you calling from, Ms. [PII]?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Children's Center.
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, it's 02477106.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] date of birth [PII].
[AGENT][NEUTRAL] OK, thank you. And what type of service is being render for benefits?
[CUSTOMER][NEUTRAL] A specialist.
[AGENT][NEUTRAL] OK, before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. And this is one of our secondary supplemental plans to the major medical.
[AGENT][NEUTRAL] And with this one, let's see.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh, right now.
[CUSTOMER][POSITIVE] I guess that's right.
[AGENT][NEUTRAL] Alright, it looks like we cover office treatment. I don't see the office there's a benefit. Bear with me just a second, let me double check.
[CUSTOMER][NEUTRAL] With the
[CUSTOMER][NEUTRAL] OK, do you see the effective date?
[AGENT][NEUTRAL] Um, yes, um, let me go back to it. One moment.
[AGENT][NEUTRAL] Effective date is [PII] and it is active at the moment.
[CUSTOMER][NEUTRAL] Mhm, uh, any co-payment?
[AGENT][NEUTRAL] OK, bear with me, let me look for the office visit benefit. I didn't find that one.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Oh, I
[CUSTOMER][NEUTRAL] Because
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] OK, so this one doesn't cover the office visit, it only covers office procedures, and the office procedures are subject to the outpatient maximum, which is 7000 per cover person per calendar year.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, so any deductible?
[AGENT][NEGATIVE] Not with us.
[CUSTOMER][NEUTRAL] No? OK, no co-payment either.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Um, and out of pocket.
[AGENT][NEUTRAL] No, there's no out of pocket where the secondary supplemental, no, it's just a maximum benefit. Mhm.
[CUSTOMER][NEUTRAL] There's no out of pocket, OK.
[CUSTOMER][POSITIVE] Perfect. OK, and what's your name?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And you have a reference number?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will.
[CUSTOMER][POSITIVE] OK perfect thank you so much OK?
[AGENT][POSITIVE] You're welcome and thank you for calling ATL. Have a good day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thank you.