AccountId: 011433970860
ContactId: 0ca84d52-8d63-4053-a874-e5f87aa25316
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 216979 ms
Total Talk Time (AGENT): 103814 ms
Total Talk Time (CUSTOMER): 63468 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/0ca84d52-8d63-4053-a874-e5f87aa25316_20250124T19:07_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from orthopedic specialist. I'm trying to verify benefits for a patient.
[AGENT][POSITIVE] OK, well, I can definitely help you with the benefits and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Um, so I'm not seeing it on the card like.
[CUSTOMER][NEUTRAL] I, it only says his name, the coverage, the group number, effective date, and the plan just says Medlink select group.
[AGENT][NEUTRAL] What's the group number?
[CUSTOMER][NEUTRAL] There's no member ID. OK, it's 25232.
[AGENT][NEUTRAL] 232. OK, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what's the member's name?
[CUSTOMER][NEUTRAL] It is [PII] I'm guessing it's Buddy, um, or Bud, I'm not sure it's [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah, mhm.
[AGENT][NEUTRAL] Is the last name?
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And thank you for verifying and all the information provided is a verification of benefits, not a guarantee of payment. So that policy number is 230.
[AGENT][NEUTRAL] 0708.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] Um, office visit for a specialist?
[AGENT][NEUTRAL] OK, hold on one moment, I'm just waiting for everything to come up here.
[AGENT][NEUTRAL] You said specialist?
[CUSTOMER][NEUTRAL] Yes, mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so for this policy, there's no in-office treatment or um coverage um under outpatients, so they don't have any in-office coverage.
[CUSTOMER][NEUTRAL] OK, so you, you guys don't cover specialist office visits?
[AGENT][NEUTRAL] Any type of office physician, there is, is only broken down into like inpatient and like outpatient emergency room, urgent care, like outpatient surgeries, that type of those types of services.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, let me make a note that.
[AGENT][NEUTRAL] Or facilities I should say.
[CUSTOMER][NEUTRAL] So it's outpatient surgeries?
[AGENT][NEUTRAL] Um, the outpatient benefit covers like the hospital emergency room, urgent care, um, outpatient surgeries, diagnostic testing in outpatient facilities, um, like physical therapy, mostly the outpatient facilities and then in inpatient after admission.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Alrighty, I will make a note of that. May I have a reference number please?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name, which is [PII], first initial to my last name is [PII], and then today's date.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK, thank you so much for your help today.
[AGENT][POSITIVE] You're welcome, [PII]. Was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] No, that is all. Thank you so much.
[AGENT][POSITIVE] You're welcome thanks for calling APL bye bye.
[CUSTOMER][NEUTRAL] Mainly