AccountId: 011433970860
ContactId: db6e2c7b-2ea9-41cc-8eab-0478e98e1446
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 195479 ms
Total Talk Time (AGENT): 79201 ms
Total Talk Time (CUSTOMER): 81046 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/db6e2c7b-2ea9-41cc-8eab-0478e98e1446_20250523T13:21_UTC.wav
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[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Thank you for calling EPR. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm sorry, who am I speaking with?
[AGENT][NEUTRAL] My name is [PII]. Um it's spelled [PII] and my last initial is [PII].
[CUSTOMER][NEUTRAL] OK, so hey, I'm calling because we have a location in common that she has uh APL, and we wanna know if um her APO will cover her her visit today with us. She's a new patient and she's coming in for a breast evaluation.
[AGENT][POSITIVE] Um, yes, ma'am. I can assist you with benefits. Um, first, I'll need your name and a good callback number.
[CUSTOMER][NEUTRAL] Yes, my name is [PII] and a good call um is [PII].
[CUSTOMER][NEUTRAL] 698
[CUSTOMER][NEUTRAL] Um, give me one second because I don't remember the last 1 2nd.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK, so it will be [PII].
[AGENT][NEUTRAL] Thank you, [PII]. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] For the patient it's 02518804.
[CUSTOMER][NEUTRAL] So she has a, um, with the insurance she has a co-pay of $45.
[AGENT][NEUTRAL] Please
[AGENT][NEUTRAL] OK. Yes, ma'am. And please verify her name and date of birth.
[CUSTOMER][NEUTRAL] Yes, her, her name is [PII], and her date of birth is [PII].
[AGENT][NEUTRAL] Thank you and just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII] and the policy is still active. And where will this service take place? Um, is it inpatient, outpatient, hospital, or is it an office visit?
[CUSTOMER][NEUTRAL] It's an an office visit.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] OK, for services provided in office, we cover up to $300 per visit and that's for the co-insurance and the deductible after the primary insurance processes the claim, but the co-pay for the office visit is not covered.
[CUSTOMER][NEUTRAL] OK, so the office visit, um, as a new patient, you guys don't cover it?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, OK, may I get a reference number?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. My name is [PII]. Um it's spelled [PII] My last initial is [PII] and today's date. Um, is there anything else I can assist you with?
[CUSTOMER][POSITIVE] No, everything is good, thank you so much.
[AGENT][POSITIVE] OK, thank you, [PII], for calling ATL. You have a great rest of your day. Mm bye.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Exactly.