AccountId: 011433970860
ContactId: 21409160-f9fe-4cbc-8e04-be2222736f7b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 193520 ms
Total Talk Time (AGENT): 91517 ms
Total Talk Time (CUSTOMER): 72228 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/2025/02/18/21409160-f9fe-4cbc-8e04-be2222736f7b_20250218T15:43_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, yes, good morning, [PII]. My name is [PII], and I'm calling from Neuroscience Consultants because we have one of your members coming in for a specialist office visit, and I was wondering if you guys would cover her primary insurances copay.
[AGENT][POSITIVE] OK. Well, I'll be more than happy to assist you with the member's benefits. And [PII], may I have a good contact number in case we're disconnected and then the policy number?
[CUSTOMER][NEUTRAL] Of course it's [PII] [PII].
[CUSTOMER][NEUTRAL] And this number is.
[CUSTOMER][NEUTRAL] 02587816 M as in Mary, L as in Larry, 8.
[AGENT][NEUTRAL] Thank you for that, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes, I have here [PII] and [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 that the policy is active as of [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So our policy pays towards the copay, deductible and co-insurance of covered charges after primary.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And for outpatient um office visits, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm sorry, specialist offices. Hold on one moment.
[AGENT][NEUTRAL] So I'm just waiting for the benefits to populate. Hold on one moment.
[CUSTOMER][POSITIVE] No worries
[AGENT][NEUTRAL] OK, so the policy itself doesn't have any in-office setting coverage in terms of facility, but under the outpatient benefit, which is up to $3000 per calendar day.
[AGENT][NEUTRAL] There's an office treatment rider, which should cover all the treatment done in the office as long as it's not cosmetic.
[CUSTOMER][NEUTRAL] Cover treatment.
[CUSTOMER][NEUTRAL] And you said that was 3000 per day?
[AGENT][NEUTRAL] Mhm, per calendar day.
[CUSTOMER][POSITIVE] Uh, OK, perfect, sounds good thank you so much for all that information, [PII] and that is pretty much all that I needed. May I get a reference number for our phone call?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. And again, um the first initial to my last name is [PII]. My name is [PII] And all the information provided was a verification of benefits, not a guarantee of payment. And [PII], was there anything else I can help with?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] No, and that was it thank you so much.
[AGENT][POSITIVE] You're very welcome. Thanks for calling APL. Have a great week.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye bye.