AccountId: 011433970860
ContactId: 1a21cd9d-c4ec-4f95-90ff-8583ba4712cf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 231919 ms
Total Talk Time (AGENT): 102030 ms
Total Talk Time (CUSTOMER): 99165 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/22/1a21cd9d-c4ec-4f95-90ff-8583ba4712cf_20250422T13:10_UTC.wav
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[AGENT][POSITIVE] Thank you for calling
[AGENT][NEUTRAL] How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from Florida Women's Care. I need to, needed to verify um benefits for this patient that's in office now, please.
[AGENT][NEUTRAL] OK, I can help with that, [PII], and what is your callback number?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][POSITIVE] Thank you very much and may I have the policy number?
[CUSTOMER][NEUTRAL] Yes, uh, let's see what we have in the card here. It is.
[CUSTOMER][NEUTRAL] In hospitals benefit, is it, she has 2. Is it the inhospital benefit cert number or the outpatient benefit cert number?
[AGENT][POSITIVE] Um, I will take the outpatient, thank you.
[CUSTOMER][NEUTRAL] 02608319 ML8.
[AGENT][NEUTRAL] OK, thank you very much, [PII]. One moment, excuse me, verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you, and you're calling for outpatient benefits. Uh, give me one second. Would this be for an office setting or a facility?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] This is an office setting. Uh she um is coming in from maternity services.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, thank you. Give me one second to check the benefits for that.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Uh, this policy shows effective as of [PII]. It shows that it's active and for office visits. Just checking again here one moment.
[AGENT][NEUTRAL] And I do apologize, this policy does not cover for an office visit fee.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] Does not cover an office visit, you said?
[AGENT][NEUTRAL] Correct, it does not cover the fee, no, it does not cover the fee.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Does it cover her ultrasound, diagnostic ultrasounds in office?
[AGENT][NEUTRAL] OK, now she does have a writer on the policy to help with services inside the office and that pays up to, um, please note verification of benefits provided that's not guarantee payment. We pay up to $750 per calendar day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and that obviously includes the ultrasound, correct?
[AGENT][NEUTRAL] It includes services diagnostic services inside the office of course for covered services so we pay up to $750 per day.
[CUSTOMER][POSITIVE] Per day. OK, perfect, 750 per day.
[CUSTOMER][NEUTRAL] Alright and then what about like her delivery and all that that would she be able to use this plan or would that have to go through her primary?
[AGENT][NEUTRAL] Uh well, it will go through her primary first and then it comes to us. She does have inpatient benefits as well under this policy.
[CUSTOMER][NEUTRAL] OK. What are her inpatient benefits for um delivery and then?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm sorry, go ahead.
[AGENT][NEUTRAL] We pay up to $2000 for the calendar, excuse me, for per confinement, per confinement, so we pay up to $2000 per confinement.
[CUSTOMER][NEUTRAL] For confinement, OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. And then, um,
[CUSTOMER][NEUTRAL] No author anything required for this correct?
[AGENT][NEUTRAL] That is correct because we are secondary.
[CUSTOMER][NEUTRAL] OK. Um, and then, OK, can you just verify your claims address with me, please?
[AGENT][NEUTRAL] I sure can. It is APL claims [PII].
[CUSTOMER][POSITIVE] [PII]. OK, thank you so much. May I just have a reference number for the call, please?
[AGENT][NEUTRAL] Um, you're welcome. We do not provide reference numbers, [PII]. You can use my name [PII] last initial [PII], and today's date.
[CUSTOMER][POSITIVE] OK, thank you so much, [PII] for all your help.
[AGENT][POSITIVE] Yeah, you're welcome and thank you for calling APL. Have a good day. You take care.
[CUSTOMER][NEUTRAL] Bye bye you too.