AccountId: 011433970860
ContactId: fed1b780-7688-4563-8d45-b4c4246e49b5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 115559 ms
Total Talk Time (AGENT): 61811 ms
Total Talk Time (CUSTOMER): 45344 ms
Interruptions: 1
Overall Sentiment: AGENT=1.7, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/13/fed1b780-7688-4563-8d45-b4c4246e49b5_20250113T17:10_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I was calling to verify eligibility for a member.
[AGENT][POSITIVE] Yes, ma'am. I can assist you with benefits. Um, first, I'll need your name and a good callback number.
[CUSTOMER][NEUTRAL] Yes, my name is [PII] with Eisenhower and the phone number is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. Now, could I get the policy number, please?
[CUSTOMER][NEUTRAL] Um, it doesn't really show a policy number. It just shows a group number.
[AGENT][NEUTRAL] Um, do you see the outpatient certificate number?
[CUSTOMER][POSITIVE] Yes, I do.
[AGENT][NEUTRAL] OK. What's that number? Yes, ma'am.
[CUSTOMER][NEUTRAL] So it would be that one? OK, 02.
[CUSTOMER][NEUTRAL] 579.
[CUSTOMER][NEUTRAL] 497 M as in Mary, L as in Larry 8.
[AGENT][NEUTRAL] Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Yes, it's [PII]. Date of birth [PII].
[AGENT][NEUTRAL] OK. And just let me advise you that verification of coverage does not guarantee payment of claims. Um, 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] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Office visit.
[AGENT][NEUTRAL] OK. For office treatments, we cover up to 500 per day and that's for the co-insurance and the deductible after the primary insurance processes the claim, but the co-pay for the office visit is not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, all right, that's good to know. OK, thank you.
[AGENT][NEUTRAL] OK. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] No, that's all.
[AGENT][POSITIVE] OK. Well, I thank you again, [PII] for calling APL. You have a great day. Mm bye.
[CUSTOMER][POSITIVE] Thanks you as well bye.
[AGENT][POSITIVE] Mhm thank you.