AccountId: 011433970860
ContactId: e614665d-4f76-487a-92a0-2885fb88b0a1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 163309 ms
Total Talk Time (AGENT): 100056 ms
Total Talk Time (CUSTOMER): 55282 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/e614665d-4f76-487a-92a0-2885fb88b0a1_20250429T18:07_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. I'm calling from a dermatologist's office for patients benefits and eligibility, please.
[AGENT][NEUTRAL] Yeah, I can take the eligibility and benefits too. Uh, what was your name please?
[CUSTOMER][NEUTRAL] No, I
[CUSTOMER][NEUTRAL] Don't think
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK, [PII], can I get a call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] A callback number, yes, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] mean
[CUSTOMER][NEUTRAL] Yes, 02462046 ML 8.
[AGENT][NEUTRAL] OK, and what was the name and date of birth for the member, please?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that. Uh, so this policy is active. Effective date was [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays.
[AGENT][NEUTRAL] And of course I will let you know verification of coverage is not a guarantee of payment for claims, uh, so the outpatient benefit for this policy is on a per calendar day basis it pays $3000 per calendar day. There is no yearly maximum.
[CUSTOMER][NEUTRAL] And what does that mean like per day? Like I don't just.
[AGENT][NEUTRAL] So daily maximum, yes, so it's a daily maximum of $3000. So if he went to uh your provider's office for treatment and then had to go somewhere else that same day, uh, it would all take from that $3000 for that day. But if he had to come back the following day, it would be like a new $3000. Does that make sense?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Got you, yes, yes, that makes sense. Calendar day, OK, and uh secondary covers co-pay and deductibles.
[AGENT][NEUTRAL] Co-pay deductible and co-insurance.
[AGENT][NEUTRAL] It is very reliant on uh major medical, so as long as whoever he has as his primary, as long as they're willing to pay this policy can if they're not, this policy can't.
[CUSTOMER][NEGATIVE] Deductive
[CUSTOMER][NEUTRAL] OK, got it. OK, um.
[CUSTOMER][POSITIVE] OK perfect and that was everything I needed thank you so much for your help and information. May I have your name and a reference number please?
[AGENT][NEUTRAL] Of course, yeah.
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date and signing is spelled [PII] last initial is A. So was there anything else I could help you with, [PII]?
[CUSTOMER][POSITIVE] No, that was everything thank you.
[AGENT][POSITIVE] Alright, yeah, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.