AccountId: 011433970860
ContactId: 9cbe3c9d-64a2-4169-8c78-5ede5b7233c0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 258600 ms
Total Talk Time (AGENT): 124182 ms
Total Talk Time (CUSTOMER): 43120 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/9cbe3c9d-64a2-4169-8c78-5ede5b7233c0_20250417T20:25_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] and I'm calling to verify benefits for a patient.
[AGENT][NEUTRAL] OK, Ms. [PII], I can help you with benefits. Can I please get your callback number, ma'am, just in case the call gets disconnected?
[CUSTOMER][NEUTRAL] [PII] no extension.
[AGENT][NEUTRAL] Thank you ma'am. And then what is the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Baptist Sleet Center [PII].
[AGENT][NEUTRAL] OK, and may I get the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, let me look that up real quick.
[AGENT][NEUTRAL] OK, I do show that [PII] does have an active policy. His effective date is [PII], and this is just to verify his benefits. It's not a guarantee of payment.
[AGENT][NEUTRAL] And this is a supplemental policy that's billed secondary to the primary. It helps with deductible, co-pay, and co-insurance. He has an inpatient calendar year benefit amount of $1000 and then he adds an outpatient per calendar day benefit amount of $500.
[CUSTOMER][NEUTRAL] OK, now this is for a sleep study to be done at his home, which is technically outpatient, but because it's at his home, I was trying to confirm if that's gonna be covered, a covered benefit.
[AGENT][NEUTRAL] Right. Let me look and see on his policy, what it says about sleep study.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's gonna be just a second so the computer can pull it up for us.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] OK, and um this is.
[AGENT][NEUTRAL] What his policy states is, um.
[AGENT][NEUTRAL] Uh, an approved facility, a hospital emergency room, urgent care facility, surgery in hospital, outpatient facility, or freestanding outpatient surgery center, a diagnostic inhospital, outpatient facility, or MRI facility.
[AGENT][NEUTRAL] Outpatient treatment for a mental or emotional disorder in a hospital outpatient facility, physical therapy, and ambulance. It does not mention that he can have services at home.
[CUSTOMER][POSITIVE] OK, that's what I wanted to confirm. thank you so much for your help and I hope you enjoy the rest of your day.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Well, thank you. I appreciate you calling APL. Is there anything else that we can help with before we go?
[CUSTOMER][NEUTRAL] No, that's it.
[AGENT][POSITIVE] OK, well, you have a wonderful [PII] and thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you you too goodbye.
[AGENT][NEUTRAL] All right. Bye-bye, Ms. [PII].