AccountId: 011433970860
ContactId: 0b1b3b52-65b9-4048-a083-129e2ff3dc86
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 160419 ms
Total Talk Time (AGENT): 79252 ms
Total Talk Time (CUSTOMER): 97605 ms
Interruptions: 8
Overall Sentiment: AGENT=2.1, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/11/0b1b3b52-65b9-4048-a083-129e2ff3dc86_20250411T13:41_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning, [PII]. I'm calling to verify benefits for a patient, please.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the benefits. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] My name is [PII] and it's [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Thank you the policy number is 02560099M as in Mary L as in Larry 8.
[AGENT][NEUTRAL] Thank you for that. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [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 [PII].
[CUSTOMER][NEUTRAL] the information
[CUSTOMER][NEUTRAL] of the.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And it's gonna affect us since [PII].
[AGENT][NEUTRAL] And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] I need benefits for a specialist office visit.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] So the policy itself, this is a secondary insurance. It doesn't have any coverage for like the office setting, um, but under the outpatient.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] Have any colors for like the aesthetic um.
[CUSTOMER][NEUTRAL] Outpatient
[AGENT][NEUTRAL] Calendar max of $6000. There is the office treatment writer.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Is that?
[AGENT][NEUTRAL] In which the treatment in the office could be covered as long as it's not cosmetic.
[CUSTOMER][NEUTRAL] With the treatment in the.
[CUSTOMER][NEUTRAL] But as long as it's not OK, and treatment would be if they do like X-rays, ultrasounds, injections, procedures.
[AGENT][NEUTRAL] Any treatment in office, yeah. Any, anything they receive in office.
[CUSTOMER][NEUTRAL] Any treatment in the office, yeah, any, anything that would be in office.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Have they met any of that 6 $6000 yet?
[AGENT][NEUTRAL] Let's see, hold on one moment.
[CUSTOMER][NEUTRAL] Let's see how that works
[AGENT][NEUTRAL] So she's used $544.
[CUSTOMER][NEUTRAL] So did you ask
[AGENT][NEUTRAL] She has $5,456 left for the year.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] OK awesome thank you so much for your help, [PII].
[AGENT][POSITIVE] You're welcome, [PII]. Was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] That's it.
[AGENT][POSITIVE] Alright, well thanks for calling APL and again all the information provided was a verification of benefits, not a guarantee of payment. I hope you have a great weekend.
[CUSTOMER][NEUTRAL] I've never been
[CUSTOMER][POSITIVE] Yeah. I hope you have a great weekend. Same to you. Bye.
[AGENT][POSITIVE] Thank you. Bye bye.