AccountId: 011433970860
ContactId: c1bba0dc-0949-4dd4-81e4-17a614fee452
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 271369 ms
Total Talk Time (AGENT): 109755 ms
Total Talk Time (CUSTOMER): 65718 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/c1bba0dc-0949-4dd4-81e4-17a614fee452_20250505T19:12_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, [PII], I am needing to get uh medical benefit information for a member please.
[AGENT][NEUTRAL] OK, I can barely hear you. Are you on speaker?
[CUSTOMER][NEUTRAL] Uh, yes, I am.
[AGENT][NEUTRAL] OK, I can barely hear you.
[CUSTOMER][NEUTRAL] Is this better?
[AGENT][NEUTRAL] That's better. And your name?
[CUSTOMER][NEUTRAL] My name is [PII], last initial [PII].
[AGENT][NEUTRAL] [PII]? OK.
[AGENT][NEUTRAL] OK, thank you. And what's the policy number [PII]?
[CUSTOMER][NEUTRAL] It is 0258.
[CUSTOMER][NEUTRAL] 6392.
[AGENT][NEUTRAL] 025863992.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and benefits for service in a doctor's office setting or outpatient facility?
[CUSTOMER][NEUTRAL] Do doctor's office.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And verify the patient's name and date of birth, please.
[CUSTOMER][NEUTRAL] [PII]. Date of birth [PII].
[AGENT][POSITIVE] Thank you for that information.
[AGENT][NEUTRAL] And I have some information for you. I'm showing the policy effective date is [PII]. Uh, this policy is active at this time.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, let me check the benefits. It shows that for an office service or service in the office, the benefit is $50 per day, uh, with the maximum of 4 days per calendar year. Um, I don't show any claims on file for this patient at this time.
[AGENT][NEUTRAL] Of course
[CUSTOMER][NEUTRAL] No, she just provided this insurance today.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And of course information provided is verification, uh, not a guarantee of payment.
[AGENT][NEUTRAL] And any other questions, [PII]?
[CUSTOMER][NEUTRAL] Um, yes, can you give me the coverage for, um.
[CUSTOMER][NEUTRAL] X-rays and labs and.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] In office.
[CUSTOMER][NEUTRAL] Yeah, everything in office and her well woman exam.
[AGENT][NEUTRAL] Yeah,
[AGENT][NEUTRAL] Yeah, the max is up to.
[AGENT][NEUTRAL] $50 no matter what takes place in the in the office, the maximum payable is $50.
[AGENT][NEUTRAL] And let me pull up her policy to verify what's covered or if wellness is covered.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And, uh, is it, uh, Will Womanchek?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so, uh, wellness is not covered under this policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, is this like a, a limited indemnity plan or limited medical benefit plan?
[AGENT][POSITIVE] That is correct.
[AGENT][NEUTRAL] It is a limited hospital indemnity policy, you're correct.
[CUSTOMER][NEUTRAL] OK, so there's no, uh, like co-insurance or deductible or out of pocket?
[AGENT][NEUTRAL] Correct, it just pays up to $50 of the total bill charge.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Alright [PII], do you have a call reference number?
[AGENT][NEUTRAL] Mhm you'll use my name in today's date is your reference T as in Tom.
[AGENT][NEUTRAL] O N Y A
[AGENT][NEUTRAL] And first initial of my last name is [PII] and any other questions?
[CUSTOMER][NEUTRAL] No ma'am, that's all I needed.
[AGENT][POSITIVE] OK, well thank you for calling APL have a good day.
[CUSTOMER][POSITIVE] Thank you you as well.
[AGENT][NEUTRAL] Uh bye bye.
[CUSTOMER][NEUTRAL] Bye bye.