AccountId: 011433970860
ContactId: acb2050f-8444-4f14-8d36-3d86a6bae700
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 226339 ms
Total Talk Time (AGENT): 85639 ms
Total Talk Time (CUSTOMER): 105630 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/acb2050f-8444-4f14-8d36-3d86a6bae700_20250327T21:29_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, [PII]. This is [PII] from, uh, maternal fetal medicine. I'm calling to confirm benefits for a member, please.
[AGENT][POSITIVE] All right. I'm happy to check on benefits today, [PII]. Uh, do you have the patient's policy number?
[CUSTOMER][NEUTRAL] I do. It is.
[CUSTOMER][NEUTRAL] Oh, give me just one second. I'm sorry, it is.
[CUSTOMER][NEUTRAL] Honestly I'm not really sure what is the.
[CUSTOMER][NEUTRAL] Member ID number in this card but let me.
[AGENT][NEUTRAL] Do you see anything that says like certificate number in hospital or?
[CUSTOMER][NEUTRAL] It says like
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] Yeah, I visited here the outpatient one will be the one I guess it's um.
[CUSTOMER][NEUTRAL] 1 I'm sorry 0197.
[CUSTOMER][NEUTRAL] 855-7.
[CUSTOMER][NEUTRAL] M as in Mary, L as in Larry, 8.
[AGENT][POSITIVE] OK. Thank you so much, [PII]. And then do you have a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] Um, yes, it will be [PII].
[AGENT][POSITIVE] Thank you so much. Uh, what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Her name is [PII] and her date of birth is [PII].
[AGENT][NEUTRAL] Alright, thank you so much. So the patient is active. Uh, the effective date on the plan is [PII]. We are the members' secondary insurance, so this is gonna cover deductible, co-pay, co-insurance, the primary does not.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, perfect. um, and it covers like any kind of uh procedure that you have like ultrasounds or anything related to maternity in this case?
[AGENT][NEUTRAL] Yeah, it should. Let's see what the limit is. There's usually uh.
[AGENT][NEUTRAL] Alright, so this is a verification and benefits, of course, not guarantee of payment. The outpatient benefit max for the calendar year is 7350.
[CUSTOMER][NEUTRAL] 7350.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it doesn't look like they've used anything else today as today.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Oh, so she has not used this, uh, balance for anything right now, right?
[AGENT][POSITIVE] Correct. She has the full amount remaining.
[CUSTOMER][NEUTRAL] Oh, OK, perfect. Alright, actually I think then that's all the information I needed to confirm, um, so this gap insurance is going to cover the deductible co-insurance and co-payment of the primary insurance, right? But it doesn't cover.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Mhm, that is correct, yes ma'am.
[CUSTOMER][NEUTRAL] OK perfect sir thank you very much for confirming this information. Can I please have a reference number for this call?
[AGENT][NEUTRAL] Absolutely. Call reference is going to be my name with my last initial, then today's date. My name again is [PII], that's [PII] and my last initial is [PII].
[CUSTOMER][POSITIVE] Perfect and you said today's date also, right?
[AGENT][NEUTRAL] Mhm, yes, ma'am.
[CUSTOMER][NEUTRAL] We
[CUSTOMER][POSITIVE] Perfect sir thank you so much again for this information. I hope you have a wonderful day, OK?
[AGENT][POSITIVE] You as well. Take care.
[CUSTOMER][POSITIVE] Thank you, you too. Bye bye.
[AGENT][NEUTRAL] Bye bye.