AccountId: 011433970860
ContactId: aebbff38-e886-481a-bc8e-745df39f0b6e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 160369 ms
Total Talk Time (AGENT): 86018 ms
Total Talk Time (CUSTOMER): 56277 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/aebbff38-e886-481a-bc8e-745df39f0b6e_20250310T15:34_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 morning. My name is [PII], and I'm calling you from Doctor [PII]'s office. I need to verify eligibility and benefit for a member, please.
[AGENT][POSITIVE] Sure, I could check out splitting benefits for you. uh, and then can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] I have number 02518708.
[AGENT][NEUTRAL] OK, and uh what was the name and date of birth for the insured, please?
[CUSTOMER][NEUTRAL] [PII] date of birth is [PII] I don't know if you have [PII], I'm sorry, [PII] or [PII].
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] I've got [PII], um, yes, thank you for verifying that, [PII]. Uh, so this policy is active. Effective date was [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays. And we we need to look at the inpatient or outpatient benefits?
[CUSTOMER][NEUTRAL] Outpatient benefit.
[AGENT][NEUTRAL] OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims, so their outpatient benefit is on a per calendar day basis. It pays up to $300 max per calendar day.
[CUSTOMER][NEUTRAL] $300?
[AGENT][NEUTRAL] Yes, per calendar day.
[CUSTOMER][NEUTRAL] OK. Um, now let me ask a question. Um, if the patient have a out of pocket, you also cover the out of pocket?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It does uh it goes towards um co-pay, deductible and co-insurance, um, as long as major medical is paying, this plan is very dependent on major medical. It can't be used instead. So if major medical is not willing to pay, this policy can't.
[CUSTOMER][POSITIVE] OK, yeah, OK, no problem. OK, perfect, thank you. Can I have your name again?
[AGENT][NEUTRAL] Of course.
[AGENT][POSITIVE] Yes, it's uh [PII]. And was there anything else I can help you with that man?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, and then let me have a reference number for our call.
[AGENT][NEUTRAL] Sure, that would just be my first name, last initial, and today's date, uh, so my last initial is [PII]
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] Of course, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.