AccountId: 011433970860
ContactId: f0209a50-6925-4c86-8dd6-c44ed028d36c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 421239 ms
Total Talk Time (AGENT): 139191 ms
Total Talk Time (CUSTOMER): 101065 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/f0209a50-6925-4c86-8dd6-c44ed028d36c_20250408T13:24_UTC.wav
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[AGENT][POSITIVE] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from Ascension Medical Group. I just need to verify if a patient actually has the insurance coverage, um, needed for her visit today, just seeing if she's eligible.
[AGENT][POSITIVE] I'm sure [PII] I can assist you with benefits. Um first, I'll need a good callback number just in case we're disconnected.
[CUSTOMER][NEUTRAL] OK, that number would be [PII].
[AGENT][NEUTRAL] Thank you. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] Yep.
[CUSTOMER][NEUTRAL] Um, I don't have the policy or group number. I do have her member ID. That's the only thing I have. She doesn't have a card on file or anything with us.
[AGENT][NEUTRAL] OK. What's the member ID?
[CUSTOMER][NEUTRAL] It is D as in dog 42032011.
[AGENT][NEUTRAL] OK. Yeah, I can look her up by that number. Do you have her social or either I can look her up by name and date of birth?
[CUSTOMER][NEUTRAL] Let's do name and date of birth. Um, it's for [PII] Her date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] OK, and I'm just waiting on my system. We have a couple of [PII]'s in here.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] You're fine.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Please verify her date of birth one more time.
[CUSTOMER][NEUTRAL] Um, [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, I have her policy number here if you need that.
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] Um, her policy number is 02571293.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the effective date on this policy was [PII]. The policy is still active. And is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Um, it was just for a primary care visit.
[AGENT][NEUTRAL] OK, under this policy for office visits, let's see.
[AGENT][NEUTRAL] One moment, I'm waiting for her benefits to load.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So I told [PII] I just
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] And she wanted to first let you know.
[CUSTOMER][NEUTRAL] When might be a good time for you? How, how quickly are.
[CUSTOMER][NEUTRAL] I didn't know if you
[AGENT][NEUTRAL] OK. This is actually a hospital indemnity claim. It mostly has hospital benefits, but I believe some outpatient benefits are available. If you don't mind holding, um, I'll get someone else on the line that can further assist you.
[CUSTOMER][NEUTRAL] Yeah, I just needed to see if it was actually eligible and everything so that way I can update that in our system.
[AGENT][NEUTRAL] Mm. Yes, ma'am. One moment, I'll get you over to a um claims representative that processes these claims and they can give you more benefit information.
[CUSTOMER][POSITIVE] OK thank you.
[AGENT][NEUTRAL] Mhm. No problem. One moment. Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] No that was all thank you.
[AGENT][POSITIVE] OK, well, I thank you, [PII] for calling APL in one moment, I'll get you transferred.
[CUSTOMER][NEUTRAL] Looks like she sent us
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] I love the.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][POSITIVE] Good morning. Thank you for calling ATL. This is [PII]. How may I assist you?
[AGENT][NEUTRAL] Um, hi, so. This is [PII] Meddling Claims. Um, I have a provider on the line who's calling to verify benefits for a hospital indemnity plan. Um, she needs benefits for office visits, but I'm actually not showing any, um, office visits under this policy, and she just continues to have more and more questions. So could you further assist her?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, sure. What's her name?
[AGENT][NEUTRAL] Um, her name is [PII].
[CUSTOMER][NEUTRAL] You know,
[CUSTOMER][NEUTRAL] OK. Did you get a callback number, Miss [PII]?
[AGENT][NEUTRAL] Yes, her callback number is the one that's in the system, the [PII].
[CUSTOMER][NEUTRAL] OK, and what's the policy number?
[AGENT][NEUTRAL] The policy number is 2571293 for [PII] and I verified all her information.
[CUSTOMER][POSITIVE] OK, so you verify the information for [PII]. OK dokey. So I'm ready for her. Thank you, Miss [PII].
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, thank you, so. Here she is. One moment.
[CUSTOMER][POSITIVE] Have a good day. All right. Thank you.
[AGENT][NEUTRAL] You too.
[CUSTOMER][POSITIVE] Thank