AccountId: 011433970860
ContactId: 33ac3226-7aed-4628-bd6f-b1615f86804f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 176119 ms
Total Talk Time (AGENT): 91101 ms
Total Talk Time (CUSTOMER): 55748 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/11/33ac3226-7aed-4628-bd6f-b1615f86804f_20250611T12:08_UTC.wav
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[AGENT][NEUTRAL] APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. I'm calling from urology specialty care calling to verify benefits for a patient.
[AGENT][POSITIVE] All right, I'm happy to check on benefits. Do we have a policy number for the patient?
[CUSTOMER][POSITIVE] Yes we do.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have 02104969.
[AGENT][NEUTRAL] Thank you. And then for documentation, can I get your name and a callback number, please?
[CUSTOMER][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] That callback number is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And then what is the patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Thank you. So patient is active. Effective date on here is [PII]. We are the member's secondary insurance, so this covers deductible, co-pay, co-insurance of the primary does not.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Does he have a max for outpatient services?
[AGENT][NEUTRAL] Yeah, let me take a look here, one moment.
[AGENT][NEUTRAL] All right, they're outpatient?
[AGENT][NEUTRAL] Uh, Benefit Max looks like.
[AGENT][NEUTRAL] is per occurrence, and that's $500. So it's a $500 max per incident basically.
[CUSTOMER][NEUTRAL] OK, and does he have any?
[CUSTOMER][NEUTRAL] Um, a cured.
[AGENT][NEUTRAL] Let's see if anything, nothing has been used for this year mm mm.
[CUSTOMER][NEUTRAL] Accumulated.
[CUSTOMER][NEUTRAL] Nothing for this year, so those 500 is for this year.
[AGENT][NEUTRAL] So it's per occurrence. So, for example, like if a patient was being seen, I don't know, for like a stomach ache, they would be able to be seen.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, so per visit.
[AGENT][NEUTRAL] Yeah, it's like per ailment basically like they can be seen up to $500 for one occurrence.
[CUSTOMER][NEUTRAL] Oh, I see.
[CUSTOMER][NEUTRAL] Got it per visit.
[CUSTOMER][NEUTRAL] May I have your name and a reference number please?
[AGENT][NEUTRAL] Absolutely. My name is [PII], that's [PII] my [PII] is gonna be [PII], and that is a call reference with today's date.
[CUSTOMER][POSITIVE] Perfect. OK, thank you very much for your help you have a wonderful day.
[AGENT][POSITIVE] You as well. Take care.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye bye.