AccountId: 011433970860
ContactId: f6b7d5a6-50ca-4d70-82c6-a3ae5928ab15
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 161360 ms
Total Talk Time (AGENT): 100701 ms
Total Talk Time (CUSTOMER): 49916 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/13/f6b7d5a6-50ca-4d70-82c6-a3ae5928ab15_20250113T18:43_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. With whom am I speaking?
[CUSTOMER][NEUTRAL] Hi, I'm not too sure if I'm in the right department. I'm trying to verify eligibility and benefits for a mutual patient.
[AGENT][NEUTRAL] OK, what's your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][POSITIVE] [PII] and a good call back number for you, [PII] in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII] option 1.
[AGENT][NEUTRAL] OK, thank you for that information and I can assist you with that eligibility today. Verification of coverage does not guarantee the payment of a claim. What is the member's ID number?
[CUSTOMER][NEUTRAL] 25582667
[AGENT][POSITIVE] Thank you for that information. One moment, [PII].
[AGENT][NEUTRAL] Verify the member's name and date of birth.
[CUSTOMER][NEUTRAL] [PII]'s date of birth is [PII].
[AGENT][NEUTRAL] Thank you. Verification of coverage does not guarantee the payment of a claim. I'm showing the policy has an effective date of [PII] and it's currently active. And what type of benefits do you need to verify? Because this is a cancer policy.
[CUSTOMER][NEUTRAL] Uh, first,
[CUSTOMER][NEUTRAL] Uh, just, just, uh, for specialist. I know this plan has, uh, they have, I mean, this patient has Medicare.
[AGENT][NEUTRAL] OK, so this is a, this is a cancer policy. This policy will only consider the diagnosis of malignant cancer. It's not for regular medical. Anything else but malignant cancer, OK?
[CUSTOMER][NEUTRAL] Advantage.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, yeah, they, they're coming in for oncology. OK.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] They're coming in for oncology? OK, and so it's just an office visit. So let's see, this policy does not cover office visits, OK, so office visits would not be covered and if you file a claim, you would have to submit the claim form that you submitted to the primary insurance along with the primary explanation of benefits because we will only consider the copay co-insurance or deductible from that primary, but in this case, if it's just an office visit, this policy does not cover office visits or regular labs, OK?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah, from holiday.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, anything else I can help you with?
[CUSTOMER][NEUTRAL] OK. No, that would be it. If I can get your name spelled and a car reference for a call if you have one for me, please.
[AGENT][POSITIVE] Sure, the call reference is going to be my name, [PII], last initial [PII] and today's date, that is your reference for the call. And thank you, [PII] for calling APL. You have an awesome rest of your day. Take care, OK?
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Likewise. Bye-bye.
[AGENT][NEUTRAL] Bye bye