AccountId: 011433970860
ContactId: ee6e8591-819d-48f1-9b23-5ec4c5abc35b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 146580 ms
Total Talk Time (AGENT): 73048 ms
Total Talk Time (CUSTOMER): 61822 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/ee6e8591-819d-48f1-9b23-5ec4c5abc35b_20250417T15:23_UTC.wav
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[AGENT][NEUTRAL] Contacting APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. I'm calling from Florida Center for Allergy and asthma Care, and I need to get benefits on a member.
[AGENT][NEUTRAL] I can help with benefits, and I'm sorry, I didn't catch your name.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII]. And what is that policy number that we're looking at today?
[CUSTOMER][NEUTRAL] Um, it is 02443502 ML8. Bye.
[AGENT][NEUTRAL] Thank you, and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII] date of birth [PII].
[AGENT][POSITIVE] I appreciate that. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. The policy went into effect on [PII]. It is active. Now, the, the secondary or gap insurance has both in and out of hospital benefits. Is there anything in particular that I can tell you?
[CUSTOMER][NEUTRAL] It's for a specialist office for allergy testing shots and serum to see if um it covers because everything goes towards her deductible.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] Yes, of course. Um, so what we will do, uh, for treatment within a physician's office, we'll pick up the deductible, co-payment or co-insurance up to $6000 per calendar year. Um, that's just a verification and if it's not a guarantee of payment.
[AGENT][NEUTRAL] But it does not cover the office visit co-pay. So the, the shots, that the treatment will be covered, but not the uh office visit co-pay, and it doesn't look like she's used any of her benefits, um.
[AGENT][NEUTRAL] For this calendar year.
[AGENT][NEUTRAL] So, uh,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So it'll cover the allergy testing itself, but just not the office visit co-pay she would have to pay or 775, OK.
[AGENT][NEUTRAL] That is
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK, um, and the address for the claims I have [PII].
[AGENT][POSITIVE] That's correct.
[AGENT][NEUTRAL] That's [PII].
[CUSTOMER][NEUTRAL] Central one OK.
[CUSTOMER][NEUTRAL] And a reference number for the call?
[AGENT][NEUTRAL] My name is [PII]. The first letter of my last name is [PII]. We're gonna use that today's date as a reference. Is there anything else at all that I may help with yourself?
[CUSTOMER][POSITIVE] Um, no, that would be it. Thank you so much, bye.
[AGENT][POSITIVE] OK, thanks for contacting ATI.