AccountId: 011433970860
ContactId: aa9ab29d-8146-4aa8-a7aa-92177ab822c8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 137899 ms
Total Talk Time (AGENT): 76970 ms
Total Talk Time (CUSTOMER): 87555 ms
Interruptions: 5
Overall Sentiment: AGENT=1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/aa9ab29d-8146-4aa8-a7aa-92177ab822c8_20250218T16:33_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] For contacting ATM. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hold on
[CUSTOMER][NEUTRAL] Yes, hi, my name is [PII]. I'm trying, um, calling from my dental provider's office trying to get a breakdown of benefits for a patient, please.
[AGENT][NEUTRAL] I can help with uh benefits for you. What's the policy number, please?
[CUSTOMER][NEUTRAL] Yes, it is. I'm sorry, one second, I'm grabbing it right now. OK, it is um 02315586.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII]. Her date of birth is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] I appreciate that. Thank you. Um, if I could have a callback number, please, in the event that we're disconnected?
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] I appreciate that. Thank you. Now, the policy went into effect on [PII]. It is active. This is a secondary or gap insurance, uh, that's meant to pick up the deductible, co-payment or co-insurance from their major medical. And so for outpatient services, outpatient hospital, uh, which includes treatment within the physician's office, cancer treatment, durable medical, independent labs, we'll pick up the deductible, co-payment, or co-insurance.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] I am
[CUSTOMER][NEUTRAL] Q
[CUSTOMER][NEGATIVE] I don't even
[CUSTOMER][POSITIVE] just right.
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Let me.
[AGENT][NEUTRAL] Up to $1500 per calendar day.
[CUSTOMER][NEUTRAL] So like we
[AGENT][NEUTRAL] Uh, for inpatient services, inpatient hospital, we pick up the deductible, co-payment or co-insurance up to $1500 per calendar year, and this is just a verification benefits, not a guarantee of payment for that outpatient benefit that is per calendar day.
[CUSTOMER][NEUTRAL] Yeah, yeah, yeah.
[CUSTOMER][NEUTRAL] He's like, well how do you do that?
[CUSTOMER][NEUTRAL] OK, and is there, is there dental coverage under this policy or just medical?
[AGENT][NEUTRAL] Um, this is just medical. So there's no dental, right, so there's no, um, dental uh benefits at all.
[CUSTOMER][NEUTRAL] Just medical.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, alrighty, well, that's what I needed to know. Um, I'll let her know that this is only medical. I'm sorry, this is the dentist's office.
[AGENT][NEUTRAL] Of course, yes. Um, that's right, yeah, it's, but that's what I, it's, it's for medical uh only. Now, is this the only thing that I can help you, [PII]?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Yeah, that is all. Thank you very much for your help.
[AGENT][POSITIVE] OK, thanks for contacting you too have a good day.