AccountId: 011433970860
ContactId: fcd26729-f82c-488a-893d-4f77047b98b7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 224199 ms
Total Talk Time (AGENT): 116785 ms
Total Talk Time (CUSTOMER): 65120 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/13/fcd26729-f82c-488a-893d-4f77047b98b7_20250613T22:40_UTC.wav
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[AGENT][POSITIVE] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hi, how are you? My name is [PII]. I'm calling to verify members eligibility as well as uh benefits.
[AGENT][POSITIVE] Yeah, I could check eligibility and benefits for you. uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Thank you. And then do you have that uh policy number?
[CUSTOMER][NEUTRAL] Yes, the policy number I have is.
[CUSTOMER][NEUTRAL] 01719341
[AGENT][NEUTRAL] OK, and what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] I'm so sorry, could you repeat that name and date of birth, please?
[CUSTOMER][NEUTRAL] Yes, [PII], [PII].
[AGENT][NEUTRAL] OK, got it. Thank you so much for that. OK, so this policy is active, uh, effective date for [PII] was [PII] [PII], so his birthday, um, and so this is a secondary medical policy, and it is designed to help with co-pay, deductible and co-insurance after major medical pays, and we really need to look at inpatient or outpatient benefits for this member.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Outpatient benefits?
[AGENT][NEUTRAL] OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims. That outpatient benefit is $6600 per calendar year, and if you'll give me one moment, I will see if any of that has been used.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so [PII] has used $300 of that benefit so far this year.
[CUSTOMER][NEUTRAL] OK. And let me just to confirm, the claims address I have is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] So that is our old uh claims mailing address. I do have our current one whenever you're ready.
[CUSTOMER][NEUTRAL] OK, go ahead.
[AGENT][NEUTRAL] That is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that is in [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then I've also got a uh fax number and a payer ID.
[CUSTOMER][POSITIVE] Perfect. Thank you.
[CUSTOMER][NEUTRAL] OK, go ahead.
[AGENT][NEUTRAL] So that fax number is 877.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK, and that payer ID?
[AGENT][NEUTRAL] Yes, that is 60801.
[CUSTOMER][NEUTRAL] 60801. Perfect. OK. And just to confirm, since it is a secondary medical policy, no authorization is required, correct?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][POSITIVE] OK, perfect. Thank you so very much, [PII]. Is there a call reference number?
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date. Uh so my name is spelled [PII] last initial is [PII] Was there anything else I can help you with?
[CUSTOMER][POSITIVE] No, that was it. Thank you so very much. I appreciate it. You have a lovely weekend.
[AGENT][POSITIVE] Of course, yeah you too thank you bye bye.
[CUSTOMER][POSITIVE] Thanks. Bye bye.