AccountId: 011433970860
ContactId: b403feca-45e7-4eed-8b9a-8e00fb2cc284
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 166610 ms
Total Talk Time (AGENT): 79425 ms
Total Talk Time (CUSTOMER): 66941 ms
Interruptions: 0
Overall Sentiment: AGENT=2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/b403feca-45e7-4eed-8b9a-8e00fb2cc284_20250206T16:47_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling ATL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Good morning. My name is [PII] and I wanted to get eligibility and benefits for a member, please.
[AGENT][POSITIVE] OK, sure. I can assist you with eligibility and benefits. And may I have a callback number just in case we get disconnected and where are you calling from?
[CUSTOMER][NEUTRAL] It's [PII] and I'm calling from a specialist office [PII].
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Pa
[CUSTOMER][NEUTRAL] It's D as in Delta 43728116.
[AGENT][NEUTRAL] Do you see a policy certificate number? It's gonna start with a 0 followed by 7 digits, Ms. [PII].
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yes, 2 or 02466821.
[AGENT][POSITIVE] OK, perfect. Thank you.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] It's [PII] [PII].
[AGENT][NEUTRAL] OK. Thank you, Ms. [PII]. And um before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. And we have an effective date of [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It is active at the moment and this is one of our limited hospital indemnity plan.
[AGENT][NEUTRAL] And with this one, we cover $75 per visit, maximum of 5 visits per person per calendar year.
[CUSTOMER][NEUTRAL] OK, and is that um like office visits or is that just hospital stay?
[AGENT][NEUTRAL] There will be any specialist or office visit.
[AGENT][NEUTRAL] Regular PCP mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and you said that's 75 per visit and only 5 a year.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Does he have a deductible or for procedures or just the 75 per visit?
[AGENT][NEUTRAL] Just the 75, yeah, it's just gonna be a flat amount of 75. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, do you have a reference number please?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name and today's date if you will.
[CUSTOMER][POSITIVE] All right, thank you so much for your help I appreciate it.
[AGENT][POSITIVE] You're welcome, Ms. [PII] and thank you for calling APO. Have a good day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thank you.