AccountId: 011433970860
ContactId: 9d2b74a6-9187-4a8e-896e-618a8d77fb41
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 174139 ms
Total Talk Time (AGENT): 75135 ms
Total Talk Time (CUSTOMER): 84715 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/23/9d2b74a6-9187-4a8e-896e-618a8d77fb41_20250423T17:12_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling ATO. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi yes good afternoon I'm sorry, what was your name?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] [PII] initial to your last?
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII]. OK, I'm trying to find out about a patient, um, eligibility on a patient.
[AGENT][NEUTRAL] OK, may I have your name and today's, uh, well, a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, my name is [PII] and uh phone number [PII]. 0 my gosh.
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Sure, Me policy number is 02609956.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Sure, her first name is uh [PII]
[CUSTOMER][NEUTRAL] And let me give you date of birth. One second please sorry.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Date of birth, it is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment, and I am showing that the policy is active. It's been effective since [PII].
[CUSTOMER][NEUTRAL] All right
[CUSTOMER][NEUTRAL] [PII]. OK, does she have any co-payment for specialist?
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] So this is a secondary insurance, so we don't have co-pays. We, we help pay towards the co-pay, deductible and co-insurance. Um, her calendar year max.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] For outpatient, it's going to be $6000 which does include um treatment in a physician's office, which is specialist as well.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so she hasn't met her deductible then.
[AGENT][NEUTRAL] This policy doesn't have a deductible. Her primary probably does.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Her primary probably does so this will pick everything with the insurance through her primary doesn't covered.
[AGENT][NEUTRAL] We only pay towards the copay, deductible and co-insurance after primary of cover charges.
[CUSTOMER][NEUTRAL] OK, perfect. um can I get a reference number for this call please?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date.
[CUSTOMER][POSITIVE] OK, thank you so much [PII] you have a great day OK?
[AGENT][POSITIVE] You're welcome, [PII]. You also, was there anything else I can help with?
[CUSTOMER][POSITIVE] That'll be all thank you.
[AGENT][POSITIVE] Alright, thanks for calling APL. You're welcome bye bye.
[CUSTOMER][NEUTRAL] Bye bye.