AccountId: 011433970860
ContactId: a7416ee5-f930-4515-9d0d-c0ca73002f61
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 406899 ms
Total Talk Time (AGENT): 137084 ms
Total Talk Time (CUSTOMER): 143228 ms
Interruptions: 2
Overall Sentiment: AGENT=0.4, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/a7416ee5-f930-4515-9d0d-c0ca73002f61_20250609T16:55_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. My name is [PII]. We're the provider, um, patient eligibility and benefits.
[AGENT][POSITIVE] I can help you with eligibility and benefits. [PII], can I get a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what is the policy number? Oh, go ahead.
[CUSTOMER][NEUTRAL] Just so you, so that's about to say I don't, I, they didn't, I don't know, it wasn't put into the system, but I have her last name and first name. Can I go ahead and give you that instead?
[AGENT][NEUTRAL] Uh, what is her last name?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] [PII], correct?
[CUSTOMER][NEUTRAL] Yes, uh-huh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me just one moment.
[CUSTOMER][NEUTRAL] I don't know how to say that I don't know how to say the name.
[AGENT][NEUTRAL] I don't either. That's just spelling it back to you.
[AGENT][NEUTRAL] And give me just one moment and uh first name?
[CUSTOMER][NEUTRAL] OK, I'm gonna spell it out. [PII]
[AGENT][NEUTRAL] OK, give me just, OK.
[CUSTOMER][NEUTRAL] [PII], uh, I don't know, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me just one moment.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, um, I'm showing uh a policy number, um, whenever you're ready for it.
[CUSTOMER][NEUTRAL] OK, hold on one second, and then it's active, right?
[AGENT][NEUTRAL] It is active with an effective date of [PII].
[CUSTOMER][POSITIVE] OK, great. So she is active and OK, I'm ready for the policy number when you're when you're ready.
[AGENT][NEUTRAL] It's 02483067.
[CUSTOMER][NEUTRAL] OK, 02483067?
[AGENT][NEUTRAL] Yes, ma'am, and this is secondary gap insurance.
[CUSTOMER][NEUTRAL] Yes, this is their medical supplement because it is a meddling policy.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and then is her is the group name City of Homestead?
[AGENT][NEUTRAL] Let me check on that real quick.
[AGENT][NEUTRAL] Yes, and do you need the group number?
[CUSTOMER][NEUTRAL] Um, is the group number 22392?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Perfect. Is the subscriber, I'm gonna spell the first name, [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII], yes, same last name.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I don't know how you say that I don't know.
[CUSTOMER][NEUTRAL] The, I don't even know.
[CUSTOMER][NEUTRAL] OK perfect so then your address?
[AGENT][NEUTRAL] You need our claims address? Oh, OK.
[CUSTOMER][NEUTRAL] OK, let me make, OK.
[CUSTOMER][NEUTRAL] I, I got it and then she has outpatient benefits correct?
[AGENT][POSITIVE] Yes, and give me one moment and I can pull up that policy.
[CUSTOMER][POSITIVE] Thank you, [PII].
[AGENT][NEUTRAL] And this is a verification of benefits, not a guarantee of payment. It looks like there is an outpatient benefit maximum of up to $1500 per calendar year.
[AGENT][NEUTRAL] Uh, with a $0 deductible per calendar year.
[CUSTOMER][NEUTRAL] Hi, I'm sorry you're breaking up.
[CUSTOMER][NEGATIVE] No, uh, [PII], you're, you're breaking up. I can't hear you.
[CUSTOMER][NEUTRAL] No, I'm sorry, I can't hear you.
[CUSTOMER][NEUTRAL] Can you hear me?
[CUSTOMER][NEUTRAL] Do you want to call me back? You wanna call me back at [PII]. Can you hear me?
[AGENT][NEUTRAL] Oh, can you
[AGENT][NEUTRAL] Are you able to hear me now? OK, I lost connection for a second, so I could hear you. OK, so what is the last thing that you heard and I can talk, talk to you through it.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I didn't, I don't know. I may start again. We were talking about making sure they have outpatient benefits.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, um, and so I just wanted to say that this is a verification of benefits, not a guarantee of coverage, and they have an outpatient benefit maximum of up to $1500 per calendar year.
[AGENT][NEUTRAL] With a $0 outpatient deductible?
[AGENT][NEUTRAL] And is there anything more specific um related to outpatients that you had questions on?
[CUSTOMER][NEUTRAL] Right, so they're just then they're covered for all outpatient coverage, right?
[AGENT][NEUTRAL] Yes, uh, hospital emergency room, urgent care, surgery, diagnostic testing, yeah, all of that, and they also have a, a DME writer as well.
[CUSTOMER][POSITIVE] Perfect, yeah.
[CUSTOMER][POSITIVE] Perfect. Yeah, perfect.
[CUSTOMER][POSITIVE] Alright, perfect, because I, I learned when I called that they said no just say outpatient benefits because that includes everything. I'm like oh OK.
[AGENT][NEUTRAL] OK, yeah.
[CUSTOMER][NEUTRAL] Uh, and, and then [PII]?
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] Thank you. And this is the reference number is your name, and they say, well, thank you so much for everything. I hope yep, I hope you have a great afternoon.
[AGENT][NEUTRAL] And last initial. Mhm.
[AGENT][POSITIVE] Great, thank you for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye.