AccountId: 011433970860
ContactId: 2ca89c2a-21af-4993-a71e-413f66ad6d14
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 210899 ms
Total Talk Time (AGENT): 107606 ms
Total Talk Time (CUSTOMER): 73464 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/30/2ca89c2a-21af-4993-a71e-413f66ad6d14_20250430T19:32_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. My name is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Hi, good afternoon. I'm calling to the patient.
[AGENT][NEUTRAL] OK, may I have your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] Thank you. And what is your callback number please [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and what is the policy number please?
[CUSTOMER][NEUTRAL] It's 0254.
[CUSTOMER][NEUTRAL] 4956 57 I'm sorry.
[AGENT][NEUTRAL] OK, let me just repeat that to you. I'm sorry, that was 02544957?
[CUSTOMER][NEUTRAL] 957 yes.
[AGENT][NEUTRAL] OK, thank you. Verify the patient's name and date of birth, please.
[CUSTOMER][NEUTRAL] Um, her name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Thank you so much and you're calling for outpatient benefits, is that correct?
[CUSTOMER][NEUTRAL] Um, yes.
[AGENT][NEUTRAL] OK, one moment, let me help you with that. One moment. You're welcome.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] This policy shows effective as of [PII] shows active and for outpatient benefits. Please note verification of benefits provided does not guarantee payment. We pay up to 1, excuse me $1250 for the calendar year.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Let me ask you something. She's going to do an ultrasound in an office, a specialist office.
[AGENT][NEUTRAL] Office. OK, thank you for that verification.
[CUSTOMER][NEUTRAL] Is that is that.
[AGENT][NEUTRAL] Let me check that for you one moment please.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] The member does have a benefit that could help cover with procedures or services inside the doctor's office and that falls under that $1250 calendar year max.
[CUSTOMER][NEUTRAL] So you guys covered the in the office, the ultrasound in office.
[AGENT][NEUTRAL] We, she does have a reminder to help with services or procedures, of course, coverage services and procedures inside the office.
[CUSTOMER][NEUTRAL] One
[CUSTOMER][NEUTRAL] I'm sorry, I don't, I didn't hear you well. I'm sorry. You said that it's covered in the office. It's covered, you said?
[AGENT][POSITIVE] No problem.
[AGENT][POSITIVE] OK, she does have a benefit to help with services or procedures inside the doctor's office, of course, for covered services or procedures.
[AGENT][NEUTRAL] I just can't guarantee that over the phone.
[CUSTOMER][NEUTRAL] So, OK, so let me, let me understand this. So the ultrasound is not covered in the special's office.
[AGENT][NEUTRAL] The ultrasound could be covered. It could be covered, of course we need that you'll be in the claim form, of course.
[CUSTOMER][NEUTRAL] Oh, it is covered.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] So it, it will be covered when we send the the EOB to you guys to to insurance.
[AGENT][NEUTRAL] I just can't verify over the that's OK. I just cannot verify or say for certain it will be covered, but we do help with procedures inside the office specialist office. We do help with procedures, sir, yes.
[CUSTOMER][NEUTRAL] Because I don't unders.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, perfect, um, can I have your name please so I can have it for my records.
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] Of course, my name is [PII]. My last initial is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Do you have any reference number or?
[AGENT][NEUTRAL] No, it would be my name and today's date.
[CUSTOMER][POSITIVE] OK, OK, perfect, thank you.
[AGENT][POSITIVE] You're welcome. Thank you for calling APL. Take care bye.
[CUSTOMER][NEUTRAL] I