AccountId: 011433970860
ContactId: efbc83e1-550e-4882-92af-be49bc43964b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 239380 ms
Total Talk Time (AGENT): 92060 ms
Total Talk Time (CUSTOMER): 55887 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/efbc83e1-550e-4882-92af-be49bc43964b_20250421T12:32_UTC.wav
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[AGENT][POSITIVE] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, this is [PII] with the um Lexington Ortho and Sports Medicine, and I'm needing to verify someone's policy or verify their.
[AGENT][NEUTRAL] I'm sure.
[AGENT][POSITIVE] OK. Yes, ma'am. I can assist you with benefits. Um, first, can I get a good callback number?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] OK, thank you. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] D as in Delta 45310888.
[AGENT][NEUTRAL] OK, that's not one of our policy numbers. Do you have the member's social or I can look them up by name and date of birth?
[CUSTOMER][NEUTRAL] I can give you her name and date of birth.
[AGENT][NEUTRAL] OK. What's her last name?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] And first name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, I'm waiting on my system. One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and please verify her date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I found her in our system and just let me advise you that verification of coverage does not guarantee payment of claims. Um, would you like her policy number?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK. That number is 02569870.
[CUSTOMER][NEUTRAL] And that was 02569870?
[AGENT][POSITIVE] Yes, ma'am. That's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, and is this a secondary policy or is it primary?
[AGENT][NEUTRAL] Um, this is primary and the effective date on the policy was [PII]. The policy is still active. Um, is this for inpatient or outpatient services or an office visit?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Office is it?
[AGENT][NEUTRAL] OK, under this policy for office visits, we cover up to $4 per calendar year and we pay up to $50.
[CUSTOMER][NEUTRAL] This is a specialty visit.
[AGENT][NEUTRAL] Yeah, that's for a special um the office visits, that's included. But let me make sure, one moment.
[CUSTOMER][NEUTRAL] This is
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] We make sure it's only 50. 1 moment.
[AGENT][NEUTRAL] In one moment her benefits are coming up.
[AGENT][NEUTRAL] OK. Yes, ma'am. Including um specialist office visits, we cover up to $50 per visit.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright thank you so much.
[AGENT][NEUTRAL] OK. Is there anything else I can assist you with?
[CUSTOMER][NEGATIVE] No thank you.
[AGENT][POSITIVE] OK. I thank you again, [PII], for calling APL. Have a great rest of your day. Bye.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Mhm. Thank you.