AccountId: 011433970860
ContactId: 9ebaccf3-d51e-4414-b530-05c7a53fd323
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 181669 ms
Total Talk Time (AGENT): 86583 ms
Total Talk Time (CUSTOMER): 101537 ms
Interruptions: 2
Overall Sentiment: AGENT=0.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/9ebaccf3-d51e-4414-b530-05c7a53fd323_20250203T14:27_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm calling from a pediatric cardiologist's office. I have a mom who gave me this insurance information and I'm trying to see what coverage they have for the specialist office.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I can help you. What spell your name for me.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]. Do you think I would know it by memory now. I'm sorry. They changed our phone numbers and I don't know anything. Hold on. Uh [PII].
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] What's the, the policy number?
[CUSTOMER][NEUTRAL] OK, the mom had some trouble giving it to me. She gave me the payer ID number. It's 60801.
[AGENT][NEUTRAL] OK, that's the number that you would use to submit the claim electronically.
[CUSTOMER][NEUTRAL] I figured I had and she gave me a, a number that had a letter in it as well that she said it was the patient beneficiary.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] What number is that? Mhm.
[CUSTOMER][NEUTRAL] OK. 0202565728 M as in Mary, L as in love, 8.
[AGENT][NEUTRAL] OK, that is the policy number, it's a policy certification number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect. Thank you.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] You're not gonna do it.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] His name is [PII], [PII].
[AGENT][NEUTRAL] OK, I'm showing an effective date of [PII], I'm sorry, [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this policy is active at this time and thank you for verifying his date of birth.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] And you said that you needed office visit benefit?
[CUSTOMER][NEUTRAL] Yeah, he's coming to see a specialist, a cardiologist.
[AGENT][NEUTRAL] OK, so the physician visit fee is not covered, um, but there is a treatment writer under this policy. So if there is treatment performed, covered treatment performed in the office, um, the treatment can be considered under the outpatient benefit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] One.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you want that benefit?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] Alright, so the maximum outpatient benefit for covered treatment in the office is up to $750.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Per calendar day.
[CUSTOMER][NEUTRAL] And I have
[AGENT][NEUTRAL] And the information provided is verification, not a guarantee of payment.
[AGENT][NEUTRAL] And did you have any other questions?
[CUSTOMER][NEUTRAL] Is there anything left from the $750?
[AGENT][POSITIVE] It's per calendar day, so it's a daily benefit.
[CUSTOMER][NEUTRAL] 00 sorry I sorry I missed that part, sorry, sorry, no problem. um OK.
[CUSTOMER][NEUTRAL] Um, OK. And you told me your number, I mean, I'm sorry, your name is?
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] [PII], pronounced [PII]. First initial last name is [PII]. You'll use my name in today's date as reference for today's call, [PII]. Any other questions or Cine? Any other questions I can assist with today?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] With that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] No, that's all thank you for your help.
[AGENT][POSITIVE] All [PII]. Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] OK. You too.