AccountId: 011433970860
ContactId: 06913508-71de-415c-8295-da633f6d3099
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 158779 ms
Total Talk Time (AGENT): 89538 ms
Total Talk Time (CUSTOMER): 45495 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/06913508-71de-415c-8295-da633f6d3099_20250320T20:30_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, I'm calling for benefits um for a specialist office visit and ultrasound.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Sure, I can assist you with benefits. I'm sorry. May I have your name?
[CUSTOMER][NEUTRAL] Yeah my name is [PII].
[AGENT][NEUTRAL] I see, and you're calling from provider's office is [PII]?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK. What's the name of the facility?
[CUSTOMER][NEUTRAL] Is Florida Woman Care?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. May I have a callback number just in case we get disconnected, Missy.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Is 02013326 ML 8.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK. May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Is [PII], date of birth [PII].
[AGENT][NEUTRAL] Mhm. Perfect. Thank you. All right, and before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. And this is one of our secondary supplemental plans for the major medical. Um we have an effective date of [PII] and it is active.
[CUSTOMER][NEUTRAL] No
[AGENT][NEUTRAL] And there is an outpatient maximum of 3000 per covered person per calendar year. This includes office procedures or office treatments. Um, let me check and see if it covers office visits. Bear with me. No, you will only cover office treatments. Office visits are not covered.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Got it. Only so like an ultrasound being done in the office, you guys will cover, but the visit, no.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Correct. Yes. Mhm. Yes, correct.
[CUSTOMER][NEUTRAL] All right, got it. Alright, I think that's it. What was your name again? I'm sorry.
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] OK, and a reference number?
[AGENT][NEUTRAL] And we don't have reference numbers. You can use my name in today's date if you would like this [PII].
[CUSTOMER][POSITIVE] Got it alright thanks for your help.
[AGENT][POSITIVE] You're welcome and thank you for calling APO. Have a good day.
[CUSTOMER][NEUTRAL] OK.