AccountId: 011433970860
ContactId: f7af45b9-67e7-463c-b5f2-71e799e58afc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 301739 ms
Total Talk Time (AGENT): 140504 ms
Total Talk Time (CUSTOMER): 90578 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/f7af45b9-67e7-463c-b5f2-71e799e58afc_20250117T15:18_UTC.wav
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[AGENT][POSITIVE] Morning, thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] and I'm calling from the doctor's office, Ventre Medical Associates, and I'm having questions regarding benefits. Can you please assist me on that?
[AGENT][POSITIVE] OK, sure. I can assist you with benefits, Ms. [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah, sure. It is [PII].
[AGENT][NEUTRAL] OK. And um I'm sorry, I didn't, can you repeat the last four digits of the phone number? Don't quite put those right.
[AGENT][NEUTRAL] So it's [PII].
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Yeah, uh, OK. I'll repeat it again. It is [PII] will be [PII], yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, got it. Thank you.
[AGENT][NEUTRAL] All right, and let's see.
[AGENT][NEUTRAL] OK. And what is the patient's policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] 02496150.
[AGENT][POSITIVE] All right, and thank you. One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII], the date of birth is [PII].
[AGENT][NEUTRAL] And can you repeat the name?
[CUSTOMER][NEUTRAL] Uh, [PII], the date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, thank you. OK, what type of service is being rendered for benefits?
[CUSTOMER][NEUTRAL] Uh, needing mental health benefits.
[CUSTOMER][NEUTRAL] Also need to know whether the policy will cover the Medicare Part B deductible.
[AGENT][NEUTRAL] So
[CUSTOMER][NEUTRAL] Co-pay or coinsurance.
[AGENT][NEUTRAL] OK. Let me check on that for you. And he's gonna be seeing like a specialist or is it gonna be for a therapy? What type of service is being rendered?
[CUSTOMER][NEUTRAL] Yeah, specialist, specialist.
[AGENT][NEUTRAL] The specialist office visit?
[CUSTOMER][NEUTRAL] Yes. Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer and let's see.
[AGENT][NEUTRAL] So this particular policy is one of our secondary supplemental plans to the major medical. And with this one, we do not cover the co-payment for the office visit, uh, that is not covered.
[AGENT][NEUTRAL] We only cover procedures done in the office or treatment.
[AGENT][NEUTRAL] And this is subject to the outpatient maximum, which is one moment let me go.
[AGENT][NEUTRAL] OK, the outpatient inpatient, outpatient is 2500 per covered person per calendar year, and this is a combined benefit with inpatient and outpatient service.
[CUSTOMER][NEUTRAL] 2500.
[AGENT][NEUTRAL] Yes, correct. That's only for treatments. It does not include the office visit.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] So the policy effective date uh was that?
[AGENT][NEUTRAL] The effective date on the policy is, let's see, one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII] and it is active at the moment.
[CUSTOMER][NEUTRAL] OK, so is there any termination date?
[AGENT][NEUTRAL] No, there's no termination date.
[CUSTOMER][POSITIVE] Oh, OK. Thank you so much. So it will cover the procedures, uh, that is the primary, uh, deductible co-pay or coinsurance, right?
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Correct. It will cover uh deductibles, co-payment, and co-insurance, and that's gonna be only for treatment.
[CUSTOMER][POSITIVE] OK, OK. Thank you so much, ma'am. And uh uh can you please spell your name with the last name [PII]?
[AGENT][NEUTRAL] Sure. My name is [PII].
[CUSTOMER][NEUTRAL] OK. So is there any call reference number?
[AGENT][NEUTRAL] We don't have reference numbers you can use my name in today's date if you will.
[CUSTOMER][POSITIVE] Oh yeah, thank you so much, ma'am and have a wonderful day bye bye.
[AGENT][POSITIVE] You as well thank you for calling ATL. Bye bye.