AccountId: 011433970860
ContactId: e07b69f7-fab9-45ad-bf56-f902a1789ec3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 162199 ms
Total Talk Time (AGENT): 78927 ms
Total Talk Time (CUSTOMER): 69271 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/01/e07b69f7-fab9-45ad-bf56-f902a1789ec3_20250501T12:33_UTC.wav
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[AGENT][NEUTRAL] Contacting ATL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh hello, [PII]. Very good morning. I'm calling from uh provider's office and uh this is regarding uh eligibility and uh specialist benefits.
[AGENT][POSITIVE] OK, I can certainly help with benefits and and eligibility. With whom am I speaking, please?
[CUSTOMER][NEUTRAL] Uh my name is uh [PII]. It is spelled [PII]
[AGENT][NEUTRAL] OK, thank you. What is that policy number that we're looking at today?
[CUSTOMER][NEUTRAL] 022-71385 M as in Mike, yeah, M as in Mike.
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] Oh yes, thank you. I appreciate that and the.
[CUSTOMER][NEUTRAL] LA
[AGENT][NEUTRAL] The patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, it is, uh, [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] OK, and I just need a callback number please in the event that we're disconnected.
[CUSTOMER][NEUTRAL] Uh, yes, [PII].
[AGENT][NEUTRAL] Thank you. The policy went into effect on [PII]. It is active. Now, you were wanting to know about a specialist office visit, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah, yes.
[AGENT][NEUTRAL] OK, so the, the, the office visit is not covered. Um, there is a treatment within the physician's office or, or procedures within the physician's office, and we will pick up the deductible, co-payment or co-insurance for that up to $750 per calendar day. But the office visit itself, whether it's a regular doctor or specialist, that is not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. OK, sure. So, up to $750 it will be paid.
[AGENT][NEUTRAL] Uh, well, for treatment or procedures within the physician's office, that's correct.
[CUSTOMER][NEUTRAL] Procedure.
[CUSTOMER][MIXED] OK, but office visit is not covered.
[AGENT][NEUTRAL] The office visit is not covered. That's, that's correct.
[CUSTOMER][NEUTRAL] OK. OK. Yeah, thank you. Uh, so, and the deductible, co-pay and co-insurance are, uh, paid.
[AGENT][POSITIVE] That's correct, yes, up to, up to that amount, that's correct.
[CUSTOMER][NEUTRAL] Oh, OK. OK, sure. Thank you. And is there any reference number?
[AGENT][NEUTRAL] It's uh my name and today's date. My name is [PII], and the first letter of my last name is [PII]. We'll use that today's date as our reference.
[AGENT][NEUTRAL] Is there anything else at all I can help with, [PII]?
[CUSTOMER][POSITIVE] OK, thank you. Thank you, [PII].
[CUSTOMER][POSITIVE] Uh, no, nothing else. Thank you.
[AGENT][POSITIVE] OK, well, thank you very much for contacting ATL. Have a very good morning.