AccountId: 011433970860
ContactId: 1baaab02-cbe3-462a-9ff2-137df770340b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 129000 ms
Total Talk Time (AGENT): 49570 ms
Total Talk Time (CUSTOMER): 69687 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/1baaab02-cbe3-462a-9ff2-137df770340b_20250512T14:11_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] For calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. I'm calling from a provider's office. I benefits on a patient please?
[AGENT][NEUTRAL] I can verify benefits. May I have your name and the policy number?
[CUSTOMER][NEUTRAL] Uh, my name is [PII]. Policy number is 01979752ML7.
[AGENT][POSITIVE] Thank you. And uh may I have a good callback number for you?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] Thank you. May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. Please be advised that verification of coverage does not guarantee the payment of a claim. And which benefit can I provide for you?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] For outpatient surgical procedure.
[AGENT][NEUTRAL] Outpatient per occurrence allows $500.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is it per per procedure or?
[AGENT][NEUTRAL] Per condition, yes, ma'am.
[CUSTOMER][NEUTRAL] Per condition, OK, but it's, let's suppose the patient is having two procedures. They only cover up to 500 for both.
[AGENT][NEUTRAL] Correct. If it's the same condition, if it's the same.
[CUSTOMER][NEUTRAL] On the same date of service but two different procedures.
[AGENT][NEUTRAL] OK. Is it for the same reason, the same diagnosis?
[CUSTOMER][NEUTRAL] Uh, well, I'm not sure cause usually they schedule either colonoscopy and an upper endoscopy. They have different diagnosis.
[AGENT][NEUTRAL] OK, so that'll be two separate occurrences. So it's 500 for each.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] For each, OK, and it's only, it doesn't cover office visit, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK, perfect. Alright, so can I get a reference number for the call, please?
[AGENT][NEUTRAL] Yes, ma'am. It will be my name which is [PII].
[CUSTOMER][NEUTRAL] 00, before, OK, [PII], um, has she used the 500 or is it per calendar year or is per occurrence?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] It's per occurrence.
[CUSTOMER][POSITIVE] OK perfect all right thank you so much have a good day.
[AGENT][NEUTRAL] And are you