AccountId: 011433970860
ContactId: 2e065d11-b09e-4aa1-9bbf-02b16ff95e3e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 240000 ms
Total Talk Time (AGENT): 112515 ms
Total Talk Time (CUSTOMER): 56683 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/16/2e065d11-b09e-4aa1-9bbf-02b16ff95e3e_20250616T14:30_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Good morning. I was calling to check on benefits for a member uh one.
[AGENT][POSITIVE] OK, sure, I can assist you with benefits. May I have your name?
[CUSTOMER][NEUTRAL] Yes my name is [PII].
[AGENT][NEUTRAL] Miss [PII], may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, it's D as in dad 43510455.
[AGENT][NEUTRAL] Do you see a policy certificate number? It's gonna start with the 0 followed by 7 digits?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, it's 02488561.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yes, uh, full name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you, Ms. And you said you need benefits. What type of service is being rendered for benefits?
[CUSTOMER][NEUTRAL] Uh, for office visit and ultrasound done in office.
[AGENT][NEUTRAL] OK. OK, before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage, and that's just a disclaimer. We have an effective date of [PII]. It is active at the moment and this is a limited policy.
[CUSTOMER][NEUTRAL] This is.
[CUSTOMER][NEUTRAL] A
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] And we have an office visit is covered at $50 per visit.
[AGENT][NEUTRAL] And that is a flat amount and that is maximum of 4 visits per covered person per calendar year. And again, this is not a guarantee of payment, just a verification of coverage and there is no benefit for an ultrasound. We just cover the offices and.
[CUSTOMER][NEUTRAL] Is her annual exam covered all woman's exam?
[AGENT][NEGATIVE] Preventative, no, this one doesn't cover preventative.
[CUSTOMER][NEUTRAL] It's not covered?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Does she have a deductible out of pocket?
[AGENT][NEGATIVE] Not with us.
[AGENT][NEUTRAL] This is a limited policy.
[AGENT][NEUTRAL] They made it indemnity.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um-hum.
[CUSTOMER][NEUTRAL] Um, OK.
[CUSTOMER][NEUTRAL] Lastly, could I have the reference I'm sorry, can I have the claims address?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] The address is to make claims for this one. Let me get that for you.
[AGENT][NEUTRAL] That's going to be IMA and that's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, [PII], could I have the reference number and your name?
[AGENT][NEUTRAL] We still have reference numbers. You can use my name in today's date. My name is [PII]. That's [PII], last initial [PII].
[CUSTOMER][POSITIVE] OK, thank you so much for your help, ma'am you have a good day.
[AGENT][POSITIVE] You're welcome, you soon and thank you for calling APR. Byebye.
[CUSTOMER][NEUTRAL] Mhm bye.