AccountId: 011433970860
ContactId: ee87e9c6-e2d2-49d3-be07-0758e9993cc1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 213529 ms
Total Talk Time (AGENT): 104810 ms
Total Talk Time (CUSTOMER): 62520 ms
Interruptions: 2
Overall Sentiment: AGENT=1.1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/21/ee87e9c6-e2d2-49d3-be07-0758e9993cc1_20250521T19:33_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Hi, um, good afternoon, [PII]. I was calling to get eligibility and benefits for patients.
[AGENT][POSITIVE] OK, I can check eligibility and benefits for you.
[AGENT][NEUTRAL] Uh, what was your name, please?
[CUSTOMER][NEUTRAL] Uh my name is [PII]. It's [PII]
[AGENT][NEUTRAL] OK, thank you, [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it's gonna be [PII].
[AGENT][NEUTRAL] Thank you. Do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, that is 01849188, M as in Mike, L as in Lima, 8.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] OK, and then what was the name and date of birth?
[CUSTOMER][NEUTRAL] Um, patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. So this policy terminated [PII]. If you'll give me one moment, I'll see if they have one that's active, could just be a different policy number.
[CUSTOMER][POSITIVE] OK, thank you for verifying that.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, they do have a newer policy that is currently active. Uh, let me know when you're ready and I'll give you that updated policy number.
[CUSTOMER][NEUTRAL] OK, you can go ahead.
[AGENT][NEUTRAL] OK, that is 0246.
[AGENT][NEUTRAL] 7685.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and again this one is currently active, uh, effective date for this policy was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays, and where we need to look at inpatient or outpatient benefits for this member.
[CUSTOMER][NEUTRAL] Yes, it's gonna be for um outpatient.
[AGENT][NEUTRAL] OK, alright, and then of course I will let you know verification of coverage is not a guarantee of payment for claims. The outpatient benefit is $8500 per calendar year. If you'll give me one moment, I will see if any of that has been used.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so she has used $1,687.28 so far this year.
[CUSTOMER][NEUTRAL] 1600.
[CUSTOMER][NEUTRAL] OK, and then, um, does that include coverage for the actual offices for a specialist, the co-pay?
[AGENT][NEUTRAL] Let me see if office visits are covered under this policy. One moment.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, so under this policy, office visits are not going to be covered.
[CUSTOMER][NEUTRAL] OK, so on this moment the office.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alrighty and then, um, [PII], just to get the first initial of your last name and then just a reference number for the call.
[AGENT][NEUTRAL] Sure, reference number would just be my first name, last initial, and today's date, um, so my last initial is [PII], and was there anything else I could help you with?
[CUSTOMER][POSITIVE] Um, no, that'll be it. Thank you so much, [PII].
[AGENT][POSITIVE] Of course, thanks for calling APL have a great rest of your day.
[CUSTOMER][NEUTRAL] You as well bye bye.
[AGENT][POSITIVE] Thank you, bye bye.