AccountId: 011433970860
ContactId: 35b04785-150c-471c-9d0a-2bcfade6c5f4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 147529 ms
Total Talk Time (AGENT): 67276 ms
Total Talk Time (CUSTOMER): 62640 ms
Interruptions: 0
Overall Sentiment: AGENT=2.2, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/10/35b04785-150c-471c-9d0a-2bcfade6c5f4_20250210T15:35_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hi, um, I was just, um, calling on behalf of a patient. Um, she wanted to know if, um, a KBMO fit 22 test would be covered by, um, the, uh, insurance or.
[AGENT][NEUTRAL] All right. I can help you with that. And I'm sorry, what was your name?
[CUSTOMER][POSITIVE] Alright thank you.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], thank you. And a callback number, please?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][POSITIVE] Thank you, [PII] and the policy number for the patient please.
[CUSTOMER][NEUTRAL] So, um.
[CUSTOMER][NEUTRAL] Would it be the payer ID that I see or?
[AGENT][NEUTRAL] Do you see an outpatient benefit cert number at the bottom?
[CUSTOMER][NEUTRAL] Yes, all right, so 02404350 ML 8.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII] and her date of birth, give me just one second.
[CUSTOMER][NEUTRAL] Her date of birth is [PII].
[AGENT][NEUTRAL] All right, thank you. I can help you with those benefits. Will this be, is that a diagnostic test?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. So she does have diagnostic testing.
[AGENT][NEUTRAL] It is covered whether it's performed in an outpatient facility or a doctor's office.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that is covered under her outpatient coverage of $500 per calendar day.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that is what we pay toward her deductible co-pay or coinsurance of the major medical, and that is a verification of coverage and not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK, alrighty so um.
[CUSTOMER][NEUTRAL] Would she have to like pay right now and then submit a claim?
[AGENT][NEUTRAL] Well, if the pro if she um has assignment of benefits we can pay the providers if you file the claim.
[CUSTOMER][POSITIVE] Oh OK, alrighty we can do that then thank you.
[AGENT][POSITIVE] It's my pleasure. Anything else I can help you with?
[CUSTOMER][POSITIVE] Nope, I am all set thank you so much.
[AGENT][POSITIVE] And thank you for calling APL [PII], I hope you have a wonderful day.
[CUSTOMER][POSITIVE] Thank you, you too.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.