AccountId: 011433970860
ContactId: e892beb9-ca2b-41a6-8de5-eb21d935898b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 177600 ms
Total Talk Time (AGENT): 80738 ms
Total Talk Time (CUSTOMER): 40196 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/08/e892beb9-ca2b-41a6-8de5-eb21d935898b_20250508T16:25_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, I'm going to check on benefits and eligibility for a patient.
[AGENT][POSITIVE] OK, I can check out really benefits for you. Um, what was your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Uh, policy 02559891.
[AGENT][NEUTRAL] OK, and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect, thank you for verifying that [PII]. So this policy is active. Effective date was [PII].
[AGENT][NEUTRAL] And this is a uh limited indemnity medical plan, so it pays a set dollar amount per covered procedure and office visit.
[CUSTOMER][NEUTRAL] OK, how much does it pay for office visit?
[AGENT][NEUTRAL] OK, I'm sorry we were needing to check benefits for an office visit.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, one moment, let me check that for you.
[AGENT][NEUTRAL] Was this a uh I'm sorry, a physician's office, correct?
[CUSTOMER][POSITIVE] Mm. Correct.
[AGENT][NEUTRAL] OK, of course I will let you know verification of coverage is not a guarantee of payment for claims. The office visit benefit, uh, is $100 per day.
[AGENT][NEUTRAL] Um, for a maximum of 4 days per calendar year.
[CUSTOMER][NEUTRAL] So she gets 4 visits a year?
[AGENT][NEUTRAL] Correct, uh, paying up to 4 excuse me, paying up to $100 per day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and can you make sure we are network?
[AGENT][NEUTRAL] This plan doesn't operate on a uh network you would just set that send the claim information directly to us.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And can I just have your name and reference number?
[AGENT][NEUTRAL] Your reference number would just be my first name, last initial, and today's date. Uh, so my name is spelled [PII] Was there anything else I could help you with, [PII]?
[CUSTOMER][POSITIVE] Oh, that'll be it thank you.
[AGENT][POSITIVE] Of course, 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.