AccountId: 011433970860
ContactId: b9b647f7-9aa6-499d-9f02-4461aa0da202
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 140949 ms
Total Talk Time (AGENT): 67566 ms
Total Talk Time (CUSTOMER): 101861 ms
Interruptions: 4
Overall Sentiment: AGENT=2, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/20/b9b647f7-9aa6-499d-9f02-4461aa0da202_20250220T16:20_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] calling from Vale Health Hospital, looking to verify um eligibility and to see what the coverage is for a member.
[AGENT][POSITIVE] Sure, I can check eligibility and benefits for you. Uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Of course it's [PII].
[AGENT][NEUTRAL] OK, thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Um, looks like the card says outpatient benefit cert number. OK, that is 02337502.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] M as in Mike, L as in Larry, 7.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Or excuse me, the last number is 8 for outpatient, sorry.
[AGENT][NEUTRAL] That's OK. OK, no worries, um, what was the name and date of birth for the insured please?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yep, um, patient named [PII], um, and date of birth [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that, [PII]. So this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance at major medical pays, and you did say this was uh outpatient, correct?
[CUSTOMER][POSITIVE] OK thank you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Correct, yes.
[AGENT][NEUTRAL] OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims, so that outpatient benefit is $2000 max per calendar year. If you'll give me one moment, I'll see if any of that has been used.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] not
[CUSTOMER][NEUTRAL] The $1000 for calendar year.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, none has been used so far this year.
[CUSTOMER][NEUTRAL] OK, so the plan will cover up to 2000 max per year?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, and there's no type of pre-cert or anything like that?
[AGENT][NEUTRAL] No, it's very dependent on uh major medical, so as long as uh the primary is willing to pay this policy can if they don't then this policy can't.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][POSITIVE] OK, perfect. All right, well thank you so much for all your help. I really appreciate it.
[AGENT][NEUTRAL] Of course, was there anything else I can help you with?
[CUSTOMER][NEUTRAL] No, ma'am, that'll be all.
[AGENT][POSITIVE] Alright, well thanks for calling [PII]. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] You too thanks bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.