AccountId: 011433970860
ContactId: ff1442f9-be27-40b5-9b5d-39993457b76e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 206479 ms
Total Talk Time (AGENT): 81808 ms
Total Talk Time (CUSTOMER): 88043 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/19/ff1442f9-be27-40b5-9b5d-39993457b76e_20250319T13:22_UTC.wav
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[AGENT][NEUTRAL] For contacting ATL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I am calling from Lakeland Regional Medical Center. I'm calling just to see, um, I guess just information of what you, what your company covers APL covers. A patient gave me his information, uh, for an outpatient procedure he's having. I just wanted to see if anything would be covered.
[AGENT][NEUTRAL] I can certainly help with benefits. What's the policy number, please?
[CUSTOMER][NEUTRAL] The policy number is, I have so many notes in here, 1,344,300.
[AGENT][NEUTRAL] Thank you, and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Uh, first name is [PII]. His last name is [PII], and the date of birth is [PII].
[AGENT][POSITIVE] I appreciate that. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] Yes ma'am, it's [PII] and there's no extension. You would just ask for [PII]
[AGENT][POSITIVE] I appreciate that. Thank you. Now, the policy went into effect on [PII].
[AGENT][NEUTRAL] [PII] it is active and for outpatient services what we will do is we will pay up to $500 per occasion, um, and that's just a verification of the benefits, not a guarantee of payment, but that's what the policy pays.
[AGENT][NEUTRAL] Uh, for outpatient hospital services.
[CUSTOMER][NEUTRAL] OK, and is this something that the patient has to submit after, um, or is this something that is can be used as a secondary to where he would not have to pay beforehand?
[AGENT][NEUTRAL] This is a secondary insurance and, and so, uh, we always suggest to our insured that they hand in both their major medical and this card at the same time. Um, so what you'll do is you'll file through the major medical and then you'll file through us. And it usually takes 3 to 6 business days for us to process those claims.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else at all that I can help with for?
[CUSTOMER][NEUTRAL] I'm just making some notes here.
[AGENT][NEUTRAL] Would you like to know where to send the claim, or?
[CUSTOMER][NEUTRAL] Um, no.
[CUSTOMER][POSITIVE] Yes please that would be helpful.
[AGENT][NEUTRAL] OK, um, the claims are sent to [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] That is in [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, that was uh zip code [PII].
[AGENT][POSITIVE] That's correct, yes.
[CUSTOMER][NEUTRAL] OK, so there's they'll, uh, APL pays $500 per occasion for outpatient benefits.
[CUSTOMER][NEUTRAL] Patient benefits and what was the um uh last initial to your last name please?
[AGENT][NEUTRAL] It's [PII] and we're gonna use that today's date as a reference.
[CUSTOMER][POSITIVE] OK. All right. Thank you so much, [PII]. I hope you have a good rest of your day.
[AGENT][POSITIVE] OK, well thank you for contacting ATO have a good day.