AccountId: 011433970860
ContactId: a350f2d7-25e4-4b4d-b302-382f3649aeba
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 193139 ms
Total Talk Time (AGENT): 60628 ms
Total Talk Time (CUSTOMER): 78941 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/25/a350f2d7-25e4-4b4d-b302-382f3649aeba_20250625T20:19_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] from NAS and I'm calling to verify coverage.
[CUSTOMER][NEUTRAL] I know that your OSC is having issues.
[CUSTOMER][NEUTRAL] And I
[CUSTOMER][NEUTRAL] I need assistance.
[AGENT][NEUTRAL] OK, so we just need to verify eligibility and benefits.
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, what's the patient's policy number?
[CUSTOMER][NEUTRAL] Um, 264.
[CUSTOMER][NEUTRAL] 1886.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] And the date of birth is
[CUSTOMER][NEUTRAL] Hold on. [PII], sorry.
[AGENT][NEUTRAL] Thank you. So patient is active. Effective date is [PII]. We're the members secondary insurance, so this would cover deductible, co-pay, co-insurance, the primary does not.
[CUSTOMER][NEUTRAL] Yes, here's my question. So does he have the 5500?
[AGENT][NEUTRAL] Uh, let me see what.
[AGENT][NEUTRAL] This patient's plan, their outpatient benefit max on this is per calendar day, which is $500.
[CUSTOMER][NEUTRAL] OK, and then the 5000?
[CUSTOMER][NEUTRAL] We just submitted their renewal, and they should have um 50,005,000 in hospital and 500 outpatients.
[AGENT][NEUTRAL] The 5
[AGENT][NEUTRAL] Right, and that's what I see for the inpatient, correct.
[CUSTOMER][NEUTRAL] OK, so then my other question is on the portal.
[CUSTOMER][NEUTRAL] It shows that he is effective [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] It does not show the the coverage period.
[CUSTOMER][NEUTRAL] Like it does for his prior policy, which showed [PII].
[AGENT][NEUTRAL] Yeah, it looks like this is a new certificate that was issued on [PII], yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] They just renewed.
[AGENT][NEUTRAL] So it may not just be updated as of yet since the mode of payment is, you know, monthly, but yeah, that's, you know, I do see that as well.
[CUSTOMER][NEUTRAL] OK. So, um, what was your name again, your name again, [PII]?
[AGENT][POSITIVE] Correct. Uh-huh.
[CUSTOMER][POSITIVE] OK, [PII], thank you so much.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][NEUTRAL] Mm. You too, bye bye.