AccountId: 011433970860
ContactId: 085a5afc-3f10-4e87-8624-7200e1525528
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 223240 ms
Total Talk Time (AGENT): 86589 ms
Total Talk Time (CUSTOMER): 104059 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/085a5afc-3f10-4e87-8624-7200e1525528_20250218T14:42_UTC.wav
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[CUSTOMER][NEUTRAL] I
[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is An[PII]How may I help you?
[CUSTOMER][NEUTRAL] I don't
[CUSTOMER][NEUTRAL] OK, yep phone number ending in 04[PII]Go ahead.
[AGENT][POSITIVE] Good afternoon. Thank you
[AGENT][NEUTRAL] I'm sorry, good morning.
[CUSTOMER][POSITIVE] Yes, you can go ahead, ma'am, it's gonna be a $30 copay.
[AGENT][NEUTRAL] Um, this is, I've already, this is An[PII]ith APL. I'm just, how can I assist you?
[CUSTOMER][NEUTRAL] And that's on here.
[CUSTOMER][NEUTRAL] Um, this is Ch[PII]ith Valdosta Orthopedic Associates calling to verify a patient's benefits. There you go.
[AGENT][NEUTRAL] OK, Ch[PII]may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes ma'am, it is um 22[PII]and one second on that policy number.
[CUSTOMER][NEUTRAL] There you go, just sign that top copy bottom copy is yours.
[CUSTOMER][NEUTRAL] There's that
[CUSTOMER][NEUTRAL] Policy number is 02158957. Thank you, ma'am.
[AGENT][NEUTRAL] Thank you for that. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] 6
[CUSTOMER][NEUTRAL] Yep, La[PII]date of birth is Ja[PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And I am showing the policy is active. It's been effective since Fe[PII].
[CUSTOMER][NEUTRAL] Yeah, I know.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] To
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And did you want to go over any benefits today?
[CUSTOMER][NEUTRAL] Yes, please, um, co-pay if any deductible out of pocket, um, X-ray and DME.
[AGENT][NEUTRAL] OK, so we're the 2nd
[CUSTOMER][NEUTRAL] This would be for a specialist office visit.
[AGENT][NEUTRAL] So we're the secondary insurance, so there are no co-pay co-pays applied. If there is from primary, we assist with paying the co-pay deductible or co-insurance after primary. Um, for outpatient, their benefit is $1500 per calendar year, um, which does include diagnostic testing in an outpatient hospital or MRI facility, and there is um durable medical equipment coverage as well.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] you
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] Did you want me to see uh if any of that 1500 has been used?
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] So that's the coverage per year, uh, 1500 is like a cap.
[AGENT][NEUTRAL] Right, that's the max. Mhm.
[CUSTOMER][NEUTRAL] OK, uh, covers $1500 per calendar year.
[AGENT][NEUTRAL] And none has been used for 20[PII].
[CUSTOMER][NEUTRAL] OK, covers co-pays, coinsurance, X-ray, DME, all of that.
[AGENT][NEUTRAL] Right, X-rays will be under diagnostic testing and durable medical equipment. There's a writer for it.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Um, you're gonna hold on to that, yes ma'am.
[CUSTOMER][POSITIVE] Yeah, I'm on the phone with them now yes ma'am.
[CUSTOMER][NEUTRAL] OK, 0 out of 1500 has been used as of today.
[CUSTOMER][NEUTRAL] All right, and then is there a reference number?
[AGENT][NEUTRAL] So there's no call reference number and you can use my name in today's date. The first initial to my last name is L [PII].
[CUSTOMER][NEUTRAL] And what was your first name?
[AGENT][NEUTRAL] My name is An[PII].
[CUSTOMER][POSITIVE] [PII] got you alrighty thank you enjoy the rest of your day.
[AGENT][POSITIVE] You also, Ch[PII]and thanks for calling APL. Bye-bye.
[CUSTOMER][POSITIVE] Thank you bye bye.