AccountId: 011433970860
ContactId: eda761e8-4b08-4680-817c-07a78a3bcf3b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 167520 ms
Total Talk Time (AGENT): 93968 ms
Total Talk Time (CUSTOMER): 61952 ms
Interruptions: 2
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/eda761e8-4b08-4680-817c-07a78a3bcf3b_20250130T19:01_UTC.wav
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[AGENT][NEUTRAL] For contacting ATL. My name is [PII]. How may I help you?
[CUSTOMER][POSITIVE] Hi, um, good afternoon, [PII]. I was calling to get eligibility and benefits for patients.
[AGENT][NEUTRAL] I can help with eligibility and benefits, with whom am I speaking, please?
[CUSTOMER][NEUTRAL] My name is [PII]
[AGENT][NEUTRAL] OK, thank you. And what is that policy number, please?
[CUSTOMER][NEUTRAL] That is going to be 1337111, M as in Mike, L as in Lima, 8.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] I appreciate that. I just need a callback number, please, in the event that we're disconnected.
[CUSTOMER][NEUTRAL] And that's gonna be [PII].
[AGENT][NEUTRAL] Thank you. Um, by the policy went into effect on [PII]. It is active. Now, the benefits for this, this is a secondary or gap insurance, and it's meant to pick up the deductible, co-payment or co-insurance for in and out of hospital settings only. Um, so what we will do is we will, um, pick up the deductible, co-payment or co-insurance for in and out of hospital. Uh, the outpatient hospital benefits are $2500 per calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The inpatient benefits for calendar year are $5000 per calendar year and that's just a verification of those benefits, not a guarantee of payment, but that's what this policy does, uh, is it will pick up that deductible, co-payment or co-insurance from the major medical.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, and then would that include um the actual offices there as well?
[AGENT][NEGATIVE] No, that, that does not include the office visits at all. Um, office visits are just not going to be covered on this. It's just gonna be the hospital.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] O
[CUSTOMER][NEUTRAL] OK, so it's not for any facility, um, um.
[AGENT][NEUTRAL] Uh, not anything other than a hospital. Yeah, that is strictly what it's for.
[CUSTOMER][NEUTRAL] Um, benefits for the outpatient?
[AGENT][NEUTRAL] Now, for the outpatient hospital, that's $2500 per calendar year, but that, that this only includes like the ER urgent care, that uh outpatient surgery. Um, it doesn't include any sort of office visits.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alrighty and then um [PII] just to go ahead and get the first initial to your last name and a reference number for the call today and then that'll be it.
[AGENT][NEUTRAL] Yes, um, it's K as in kite, and then we're gonna use that in today's date as a reference.
[CUSTOMER][POSITIVE] OK, alrighty, [PII], thank you so much.
[AGENT][POSITIVE] OK, thank you for contacting AP have a good day.