AccountId: 011433970860
ContactId: fdfa981a-9eb6-4094-83f5-b59fd3468583
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 336970 ms
Total Talk Time (AGENT): 93958 ms
Total Talk Time (CUSTOMER): 69010 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/07/fdfa981a-9eb6-4094-83f5-b59fd3468583_20250307T16:47_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm calling from a provider's office to verify um eligibility and and benefits for a patient.
[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] Yeah, I'm [PII].
[CUSTOMER][NEUTRAL] And my direct number is [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] It is 02567481.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And just 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. And is this for an office visit?
[CUSTOMER][NEUTRAL] Um, no, this is for an ambulance transport, an emergency.
[CUSTOMER][NEUTRAL] Or a transfer between two hospitals.
[AGENT][NEUTRAL] OK. OK, one moment.
[AGENT][NEUTRAL] And I'm waiting on my system. His benefits are coming up. One moment.
[CUSTOMER][NEUTRAL] Oh, true.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK. Yes, ma'am. Under this policy for ambulance benefits, we'll cover up to um one ambulance ride per calendar year and up to $50 per visit. Well, I'm sorry, per ride.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Does it, is there any limitation as far as like emergent versus?
[CUSTOMER][NEGATIVE] Non-emergent.
[AGENT][NEUTRAL] Um, no, ma'am. No.
[CUSTOMER][NEUTRAL] Because this wasn't a like this wasn't a 911. This was like an inter facility between hospitals.
[AGENT][NEUTRAL] Right, and that's covered, but it's only $50 if it's for ground and air is um up to $100.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So yeah, those are the only limitations, either if it's ground or air.
[CUSTOMER][NEUTRAL] That's all that would pay or that's all the patient would be responsible to pay?
[AGENT][NEUTRAL] Um, that's all they would pay.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And um can I get like a claims mailing address?
[AGENT][NEUTRAL] Um, yes, ma'am. The claim mailing address is, um, [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that's in [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[AGENT][NEUTRAL] And we also have a pair ID.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The payer ID is 64556.
[CUSTOMER][NEUTRAL] 645-556
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] All right, perfect. I will get that information added and then we'll get that claim submitted.
[AGENT][NEUTRAL] OK. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] No, that's all I had.
[AGENT][POSITIVE] OK. Well, I thank you again, [PII] for calling ATL. You have a great weekend. Mm bye.
[CUSTOMER][POSITIVE] Thanks. You too. Bye-bye.
[AGENT][POSITIVE] Thanks.