AccountId: 011433970860
ContactId: 1788e4ee-d727-47c3-8ca5-3fe0dd77b793
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 341989 ms
Total Talk Time (AGENT): 141784 ms
Total Talk Time (CUSTOMER): 103958 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/1788e4ee-d727-47c3-8ca5-3fe0dd77b793_20250408T19:53_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, good afternoon. This is [PII]. Last initial [PII], and I would like to check benefits information, please.
[AGENT][NEUTRAL] OK, I can help you with benefits, [PII]. Uh, can I please get your callback number, sir, just in case our call is disconnected or dropped.
[CUSTOMER][NEUTRAL] Uh yes, sure. So it's uh [PII].
[AGENT][NEUTRAL] Thank you, sir. And then what is the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] I'm calling from Vital MD.
[AGENT][NEUTRAL] OK, and then may I get the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Um, yes. So the full patient's full name is [PII]. Date of birth is
[CUSTOMER][NEUTRAL] [PII] and the policy number, it's 02486799ML8.
[AGENT][POSITIVE] Thank you I appreciate you verifying that information for me. Let me go ahead and pull the policy in for us.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK. I do show that [PII] does have an active policy. The effective date of the policy for her is
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And this is just to verify benefits. It's not a guarantee of payment. She has a supplemental insurance policy that is billed secondary to the primary. It helps with deductible, co-pay and co-insurance.
[AGENT][NEUTRAL] She has an inpatient benefit amount per occurrence of $3000 and then also an outpatient per calendar day benefit of $3000 to help towards deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] All right. So, and let me ask you if this $3000 will cover uh PCP office visit or co-pay for the uh office visit.
[AGENT][NEUTRAL] Let me check to see if she has office visits on her policy. I'll need to pull in the complete policy and review it. It's gonna take just a second for the computer to load it for us.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, so the office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] OK, so that means the $3000 for outpatient won't be uh.
[CUSTOMER][NEUTRAL] for office visits.
[AGENT][NEUTRAL] Not for the office visit physician fee. Now the treatment in the office, they, they do have a writer on their policy for treatment, but the physician's fee will not be covered.
[CUSTOMER][POSITIVE] Alright, so we'll be for treatment. Thank you.
[CUSTOMER][NEUTRAL] OK. So now, could you provide me please the claim's billing address?
[AGENT][NEUTRAL] OK, that is.
[AGENT][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] That's in [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] All right. And lastly, may I have your first name, last initial, and the car reference number, please?
[AGENT][NEUTRAL] Yes, my name is [PII] and the last initial is [PII]
[AGENT][NEUTRAL] And you can use my name and today's date.
[AGENT][NEUTRAL] For the reference and rushing, can I please get the name of the oh you said Vital.
[CUSTOMER][NEUTRAL] All right, so.
[CUSTOMER][NEUTRAL] Oh, I'm sorry, come again.
[AGENT][NEUTRAL] OK. Did you get my name?
[CUSTOMER][NEUTRAL] I'm sorry, what did you say?
[AGENT][NEUTRAL] Yes, did you get my name? It's [PII] OK, good. Yes.
[CUSTOMER][NEUTRAL] Oh yes, it's [PII].
[CUSTOMER][POSITIVE] Yes. OK, so thank you so much for the information, [PII], and have a great day. I really appreciate it.
[AGENT][POSITIVE] You're very welcome. Is that all I can help you with today, Braheen?
[CUSTOMER][NEUTRAL] Uh, yes, and my first name is [PII].
[AGENT][POSITIVE] Thank you very much for calling APL. I hope you have a wonderful day.
[CUSTOMER][POSITIVE] You too, take care.
[AGENT][NEUTRAL] Bye bye.