AccountId: 011433970860
ContactId: 330ce1b0-1095-470c-a630-6c5b322819be
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 170240 ms
Total Talk Time (AGENT): 98090 ms
Total Talk Time (CUSTOMER): 56950 ms
Interruptions: 0
Overall Sentiment: AGENT=2.2, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/330ce1b0-1095-470c-a630-6c5b322819be_20250109T18:53_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, [PII], my name is [PII] and I'm calling to find out if I need to get authorization for a patient to see our psychologist for a routine office visit.
[AGENT][NEUTRAL] Um, so there's no authorization required um for any of our APL policies because we're not the major medical, but if you'd like for me to go over the benefits with you, I can.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Um, sure, that would be great.
[AGENT][NEUTRAL] OK, and can, may I have a good contact number in case we're disconnected and the member's policy number?
[CUSTOMER][NEUTRAL] Yes, it's [PII] and my extension is 1105.
[AGENT][POSITIVE] Thank you for that.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] And then I'm ready for the policy number whenever you are.
[CUSTOMER][NEUTRAL] OK, let me get right back to that. OK, I have 02465498.
[AGENT][POSITIVE] Mhm. Take your time.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] OK, it is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So I am showing that the policy is active. It's been effective since [PII].
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And then what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] Uh, mental health.
[AGENT][NEUTRAL] Mental health, OK, hold on one moment.
[AGENT][NEUTRAL] I'm just waiting for the policy document to populate here.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, so under outpatient, the policy would pay up to $2000 per person per calendar year. That does include um outpatient treatment for a mental or emotional disorder in a hospital outpatient facility.
[AGENT][NEUTRAL] She also has the, um, I'm sorry, he also has the office treatment rider. So if anything is considered like in office, that um rider could assist, but in terms of just mental health, um, that outpatient benefit was the only one at the mental health facility.
[CUSTOMER][NEUTRAL] OK, alright, well that's what I need to know.
[AGENT][NEUTRAL] And there is a 30-day max.
[CUSTOMER][NEUTRAL] 30 day max. OK, alright, well that's what I needed to know. I appreciate your help. Is there a reference number for the phone call?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. So that's [PII], first initial to my last name is [PII], and then today's date.
[CUSTOMER][POSITIVE] OK, alright, [PII], thank you so much for your help you have a great day.
[AGENT][POSITIVE] Thank you also, [PII] and thanks for calling APL and happy New Year.
[CUSTOMER][POSITIVE] Happy New Year. bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.