AccountId: 011433970860
ContactId: 2790fce3-d5de-48e2-8b80-dcb76f62b249
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 200029 ms
Total Talk Time (AGENT): 111237 ms
Total Talk Time (CUSTOMER): 57053 ms
Interruptions: 1
Overall Sentiment: AGENT=2.4, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/2790fce3-d5de-48e2-8b80-dcb76f62b249_20250114T16:01_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] I thought
[CUSTOMER][NEUTRAL] Hi [PII], I'm calling for benefits for mutualation please.
[AGENT][POSITIVE] Yeah, I'd love to help you with some benefits today. Do you mind if I snag a good name and call back number from you?
[CUSTOMER][NEUTRAL] Um, [PII] call back number [PII] option 4.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Hey, thank you so much and you said [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Perfect. I just wanna make sure I was pronouncing that right for you. Do you mind if I also go ahead and get your member's policy number?
[CUSTOMER][NEUTRAL] Um, 01893411 ML 8.
[AGENT][POSITIVE] Thank you, thank you. And give me 1 2nd to get that policy pulled up for you.
[AGENT][POSITIVE] Wonderful. And would you be able to
[AGENT][NEUTRAL] Verify for me your patient's first and last name and date of birth.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] Perfect. I do see her right here. She is current and active with an effective date of [PII] and.
[AGENT][NEUTRAL] What sort of benefits can I help you out today with inpatient or outpatient?
[CUSTOMER][NEUTRAL] Outpatient, she's having.
[CUSTOMER][NEUTRAL] Let me
[CUSTOMER][NEUTRAL] Go back to see what.
[CUSTOMER][NEUTRAL] She's having a pelvic ultrasound, diagnostic testing.
[AGENT][NEUTRAL] OK, perfect. Um, so your patient has an outpatient benefit of $500 per calendar year with us.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] It does look like.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] I know that you
[AGENT][NEUTRAL] Here, let me pull up her policy documents for you real quick. One second, um, she has $500 per calendar year. I do wanna let you know any um uh any benefit information I give you over the phone is just a verification of coverage and never guarantee of payment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] Perfect thank you um and then.
[AGENT][NEUTRAL] I am
[AGENT][NEUTRAL] Pretty sure it covers diagnostics, but let me just pull up the policy and read it.
[AGENT][NEUTRAL] It says diag diagnostic testing in a hospital outpatient facility or MRI facility.
[AGENT][NEUTRAL] Um, under those outpatient benefits.
[CUSTOMER][NEUTRAL] OK, so anything over the $500 she is responsible for.
[AGENT][NEUTRAL] So because we're a secondary insurance, we can't determine patient responsibility, but she does have that benefit with us to help cover those um expenses left behind for major medical.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][POSITIVE] OK, great.
[CUSTOMER][NEUTRAL] Great, OK, well, can I have a reference number for this call, please?
[AGENT][NEUTRAL] Oh, yes, absolutely. Um it's gonna be my name, [PII], first initial, last name, [PII], and today's date.
[CUSTOMER][POSITIVE] OK thank you [PII] have a good day.
[AGENT][POSITIVE] Hey, my pleasure, thanks for calling APL and you have a fabulous day as well.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye bye.