AccountId: 011433970860
ContactId: cb4290dc-1f73-4ac8-bc6f-bbb3b9faeead
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 370250 ms
Total Talk Time (AGENT): 120255 ms
Total Talk Time (CUSTOMER): 84139 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/cb4290dc-1f73-4ac8-bc6f-bbb3b9faeead_20250206T19:05_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, uh, my name is [PII]. I'm calling from, uh, the Long Street Clinic provider's office, uh, to verify benefits, uh, and eligibility for patients.
[AGENT][POSITIVE] All right, [PII], I'm happy to check on benefits and eligibility. What is the policy number?
[CUSTOMER][NEGATIVE] So I, I called 90 degree benefits and they redirected me to you, um, and they said that the I we have maybe wouldn't work for your system.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, I have the social, um, if you can use that.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yeah, we can definitely try that. What's your social?
[CUSTOMER][NEUTRAL] Uh, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, let me try that here, one moment.
[CUSTOMER][NEUTRAL] Alright
[AGENT][NEUTRAL] What is the uh patient's first and last name, please?
[CUSTOMER][NEUTRAL] It's uh [PII].
[CUSTOMER][NEUTRAL] Uh, date of birth is [PII].
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][POSITIVE] All right, thank you so much. And we're looking for medical coverage, correct, [PII]?
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. So the patient does have an active plan with us. The effective date is [PII]. Do you need the policy number?
[CUSTOMER][NEUTRAL] Yeah, what's the policy number for you guys?
[AGENT][NEUTRAL] Uh, the policy number is going to be 246.
[AGENT][NEUTRAL] 8294.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And was there anything else you needed from the member plan?
[CUSTOMER][NEUTRAL] Um, is there a group number as well?
[AGENT][NEUTRAL] Yeah, let me take a look here.
[AGENT][NEUTRAL] Uh, group number is 70055.
[AGENT][NEUTRAL] The name is TRC Staffing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And then can you verify the claims address for me?
[AGENT][POSITIVE] Yeah, absolutely. Let me just pull that up here. One second.
[AGENT][NEUTRAL] All right, so claims are actually gonna go to IMA.
[AGENT][NEUTRAL] And so that's at [PII].
[CUSTOMER][NEUTRAL] But.
[AGENT][NEUTRAL] And [PII], zip code is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] Um, and then can you verify, um, like what sort of benefits they have for like office visits?
[AGENT][NEUTRAL] Yeah, let's take a look here.
[AGENT][NEUTRAL] OK. So for a physician office visit, it looks like the patient is allowed a maximum of 4 visits per calendar year, and the plan is gonna pay $100 per visit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Have they used any of their visits for this year yet?
[AGENT][NEUTRAL] Yeah, let's see
[AGENT][NEUTRAL] Uh, looks like the patient has used one visit this year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, uh, and is this on the, um, like multi plan PHCS network?
[AGENT][NEUTRAL] Yeah, it looks like it is, yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright, I think that's all I needed. I really appreciate your help today. Can I just get your name one more time and the reference number for our call?
[AGENT][NEUTRAL] Absolutely, [PII]. That's gonna be the call reference is my name with my last initial than today's date. My name again is [PII], that's spelled [PII] Last initial is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright, thanks again for your help, [PII], uh, and have a great rest of your day.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] You too. Bye bye.