AccountId: 011433970860
ContactId: a5b5c14e-5c7e-4996-81c4-6c67e5fdbd57
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 224100 ms
Total Talk Time (AGENT): 93722 ms
Total Talk Time (CUSTOMER): 76755 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/a5b5c14e-5c7e-4996-81c4-6c67e5fdbd57_20250421T22:18_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm trying to verify an insurance for a patient.
[AGENT][NEUTRAL] OK, we just need to check eligibility.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I could check that for you. um, what was your name please?
[CUSTOMER][NEUTRAL] My name's [PII].
[AGENT][NEUTRAL] OK, [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And do you have the policy number?
[CUSTOMER][NEUTRAL] Uh, I have, is this policy cert number? I don't know if that's the number that you're talking about. OK. Uh, 025.
[AGENT][NEUTRAL] Yes, yes, that's it.
[CUSTOMER][NEUTRAL] 57885.
[AGENT][NEUTRAL] Got it. And uh what was the name and date of birth for the member, please?
[CUSTOMER][NEUTRAL] Name is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that. So this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays.
[CUSTOMER][NEUTRAL] OK, got you.
[CUSTOMER][NEUTRAL] Oh boy. And is there anything that you can tell me specifically about, um, I mean, I know you said it's secondary, so it's supposed to help with the main insurance. Um, does it show though any amount for um like a co-pay or co-insurance, anything like that? Or just, it's just supposed to help? So does it really say anything?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Um, I'm sorry, I'm not quite understanding what you're asking the, the whole this policy, um, essentially has two buckets benefit amounts per calendar year, uh, for inpatient and for outpatient, and this benefit amount, it works with, uh, major medical, so it is very dependent on whoever they have if their major medical does not pay this policy can't, um, and so and when it does, it goes towards the uh co-pay, deductible and co-insurance.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got you. And how much is the calendar year for inpatient?
[AGENT][NEUTRAL] This policy on its own doesn't have any.
[AGENT][NEUTRAL] Sure, um
[CUSTOMER][NEUTRAL] Oh, OK, OK, got you.
[AGENT][NEUTRAL] You said for inpatient?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims. The inpatient benefit is $4000 max per calendar year. If you give me one moment, I'll see if any of that has been used.
[CUSTOMER][POSITIVE] OK, perfect. Thank you so much.
[AGENT][NEUTRAL] OK, so she has not used any of that inpatient benefit this year.
[CUSTOMER][POSITIVE] Got you, perfect.
[CUSTOMER][POSITIVE] Great. Thank you so much.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Are you still there sir?
[CUSTOMER][NEUTRAL] I go.
[CUSTOMER][NEUTRAL] Yes, sorry, I think it just went blank for a little bit.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Can you hear me?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Can you hear me?
[AGENT][NEUTRAL] [PII], are you still there?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Can you hear me?
[CUSTOMER][NEUTRAL] Hello?