AccountId: 011433970860
ContactId: ef8a41c0-06a8-407a-9a2f-72252d00810b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 155759 ms
Total Talk Time (AGENT): 74591 ms
Total Talk Time (CUSTOMER): 75470 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=3.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/10/ef8a41c0-06a8-407a-9a2f-72252d00810b_20250210T23:27_UTC.wav
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[AGENT][POSITIVE] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Hi, good good evening. How are you?
[AGENT][POSITIVE] I'm doing well how are you?
[CUSTOMER][POSITIVE] I'm doing good. Thank you so much for asking. I'm giving you a call from um a, an outpatient urgent care center. I wanted to get the eligibility and benefits of a patient.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I don't have any portal for you guys, so I just wanted to see if he was currently active.
[AGENT][NEUTRAL] Sure, yeah, I can check eligibility and benefits for you. Um, what was your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK, and [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] I'm going to tell you the callback number right now. It is [PII] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you and then do you have the policy number?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] I do. So, OK, on the card, the patient gave me, well, I see the patient's um group number and hospital benefit certification number and outpatient benefit certification number. Would it be that one? Or would it be the payer ID?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Either one of those
[AGENT][NEUTRAL] Uh, no, so either one of those certification numbers is perfectly fine.
[CUSTOMER][NEUTRAL] OK, so let me give you the outpatient one. It is 02450150 M as in Mary, L as in Larry, and then the number 8.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] And then what was the name and date of birth for the insured please?
[CUSTOMER][NEUTRAL] Patient's name is [PII] and his date of birth is [PII].
[AGENT][NEUTRAL] Perfect. OK, thank you for verifying all of that, [PII]. Uh, so this policy is active. Effective date 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.
[CUSTOMER][NEUTRAL] Of course.
[AGENT][NEUTRAL] Let's see and so we were checking the outpatient benefits correct?
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims, uh, so their outpatient benefit is on a per calendar day basis and this policy pays $3000 max per calendar day.
[CUSTOMER][POSITIVE] Perfect. OK, that's all the information I needed. Can I please get your first name and the initial for your last name?
[AGENT][NEUTRAL] Sure it's uh [PII] last initial is [PII] Was there anything else I could help you with, [PII]?
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] That'll be all. Thank you so much, [PII]. Have a wonderful rest of your your night.
[AGENT][POSITIVE] All right. Yeah, you too. Thank you. Bye bye.
[CUSTOMER][POSITIVE] Alrighty bye bye.