AccountId: 011433970860
ContactId: f9603976-2406-42ac-80f2-05dd1be7a96e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 242179 ms
Total Talk Time (AGENT): 78095 ms
Total Talk Time (CUSTOMER): 155600 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/f9603976-2406-42ac-80f2-05dd1be7a96e_20250303T14:44_UTC.wav
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[AGENT][POSITIVE] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Um, I want you to verify benefits for patient, please.
[AGENT][NEUTRAL] Um, yes, ma'am. I can assist you with benefits. Um, first, could I get your name and a good callback number?
[CUSTOMER][NEUTRAL] My first name is [PII] and I'm sorry, I didn't get yours. I know you said it, but I couldn't hear it.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Um, my name is [PII]. Um, it's spelled [PII] and my last initial is [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and my phone number direct line is [PII] is my direct line like I said.
[AGENT][NEUTRAL] OK, thank you, honey. Now, could I get the policy number, please?
[CUSTOMER][NEUTRAL] it's
[CUSTOMER][NEUTRAL] Uh, policy outpatient 02224468 M as in Mary, L as in love 8 and the number 8 sorry.
[AGENT][NEUTRAL] And thank you and please verify.
[CUSTOMER][NEUTRAL] I gotta come up with something different.
[AGENT][POSITIVE] Oh no problem.
[CUSTOMER][NEUTRAL] Uh, the patient's name, the insured's name is [PII], but this is for her son [PII]. He's the patient.
[AGENT][NEUTRAL] And his date of birth, please?
[CUSTOMER][NEUTRAL] I knew you were gonna ask me that, so I saved this other paper, huh? I'm with the program, uh, [PII].
[AGENT][POSITIVE] Great.
[AGENT][NEUTRAL] OK, and just
[CUSTOMER][NEUTRAL] Well they were here. He was my very first patient at [PII] this morning, so hello.
[AGENT][POSITIVE] Oh wow.
[AGENT][NEUTRAL] And on a Monday, on top of that.
[CUSTOMER][NEUTRAL] That's what I said.
[CUSTOMER][NEUTRAL] Mm, and she comes in with other insurance like why didn't you call us on Friday so we can do this before you got here because that would have been logical.
[AGENT][NEGATIVE] Uh oh, no.
[AGENT][NEUTRAL] And with this, let me advise you that verification of coverage does not guarantee payment of claims. The effective date on this policy was [PII] and the policy is still active. Um, is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Outpatient, no outpatient free standing ambulatory surgical facility outpatient for sure.
[AGENT][NEUTRAL] OK, for outpatient, we cover up to $1000 per day and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim.
[CUSTOMER][NEUTRAL] OK, so it'll be $1000 for the just today because her alright well that's not gonna fly she's gonna owe me some money then and she's still here because it was a lengthy procedure.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] But let me log in because I think do do do do do where am I in the DSC.
[CUSTOMER][NEUTRAL] OK, pause [PII] oh wait, I have to go into clarity for him.
[CUSTOMER][NEUTRAL] There it is.
[CUSTOMER][NEGATIVE] Uh, log back in. I hate computers. They have way too many male genes in them.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, where's my pause person?
[CUSTOMER][NEUTRAL] There he is, he had to do to do a $500 deductible.
[CUSTOMER][NEUTRAL] And then his insurance covers 20% so they were supposed to pay me $1500 1500 dollars today. His 20% alone is is um $1000.
[CUSTOMER][NEUTRAL] And then 500 for his copay.
[CUSTOMER][NEUTRAL] Or deductible, but he may have met that elsewhere so.
[CUSTOMER][NEGATIVE] He's still gonna owe me money.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Yeah, she has a little help, 1000. I'm sure she'll appreciate that. I know I would.
[CUSTOMER][NEUTRAL] Yeah, yeah, 1000 bucks is 1000 bucks, so they're still sitting in the lobby, I guess I gotta go hit her for it. Alright, thank you so much, [PII]. Oh, a reference number for the call?
[AGENT][NEUTRAL] It is.
[AGENT][NEUTRAL] You can use my name and today's date. Is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] Um, no, you can just have yourself a really good day.
[AGENT][POSITIVE] You do the same, honey. Thank you for calling APL. bye.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mm bye bye.