AccountId: 011433970860
ContactId: ef80139e-93ae-464e-84fb-c75e0a1e8ca1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 354059 ms
Total Talk Time (AGENT): 96651 ms
Total Talk Time (CUSTOMER): 60971 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/ef80139e-93ae-464e-84fb-c75e0a1e8ca1_20250130T16:52_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling ATL. My name is [PII]. How may I help you?
[CUSTOMER][POSITIVE] Hi, uh, this is [PII] with Ideal Option. I'm calling.
[CUSTOMER][NEUTRAL] Um, just to verify, uh, benefits and eligibility and to see if the member's plan covers substance abuse.
[AGENT][POSITIVE] OK, well, I'll be more than happy to assist you with the eligibility and the benefits. And [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the policy number is 025928882.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment, and I am showing that the policy is active. It's been effective since [PII].
[AGENT][NEUTRAL] And hold on one moment, I'm just pulling up the benefits so I can see that for substance abuse.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] No, I'm asking.
[CUSTOMER][NEUTRAL] Yes, yes, I just need to see if substance abuse is a covered service because I know this is an indemnity plan, so I'm not sure what all would be covered.
[AGENT][NEUTRAL] Alright, do you mind if I place you on just a brief hold? I'm just pulling up the policy benefits.
[CUSTOMER][NEUTRAL] OK, sure, of course.
[AGENT][NEUTRAL] All right, hold on one moment.
[CUSTOMER][NEUTRAL] OK, thanks. You are on hold.
[AGENT][NEGATIVE] Lord, I forgot the name. It took so long.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] Uh, that is not what I want to do.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello [PII].
[AGENT][POSITIVE] Thank you so much for holding. I apologize I apologize for that wait. Are you all considered like an outpatient facility? Yes, can you hear me?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, I'm here.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes, can you hear me?
[CUSTOMER][NEUTRAL] Yes, I can hear you.
[AGENT][NEUTRAL] OK, um, so the, the indemnity policy kind of breaks it down by
[CUSTOMER][NEUTRAL] Can you hear me?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] There may be a delay.
[CUSTOMER][NEUTRAL] Yeah, I think there is, yeah.
[AGENT][NEUTRAL] OK, so I'll pause after I speak.
[CUSTOMER][NEUTRAL] What was that?
[AGENT][NEUTRAL] I'll pause after I speak just in case there's a delay.
[CUSTOMER][NEUTRAL] Oh, OK, OK, alright.
[AGENT][NEUTRAL] So the policy breaks down um by place of service. Are you all, would it be like a physician's office or you're an outpatient facility?
[CUSTOMER][NEUTRAL] It's a specialist office visit?
[AGENT][NEUTRAL] OK, so for the
[CUSTOMER][POSITIVE] Yeah, we specialize in addictive outpatient treatment, uh.
[AGENT][NEUTRAL] For the physician office, there is a benefit of $50 per day with a max of 4 days per calendar year.
[CUSTOMER][NEUTRAL] OK, and this is for like a specialist or just a primary care provider?
[AGENT][NEUTRAL] I'm checking that now typically under