AccountId: 011433970860
ContactId: 38a448ed-c1cc-4285-b633-3bd7a31931fd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 166559 ms
Total Talk Time (AGENT): 67390 ms
Total Talk Time (CUSTOMER): 79512 ms
Interruptions: 1
Overall Sentiment: AGENT=2.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/38a448ed-c1cc-4285-b633-3bd7a31931fd_20250219T17:53_UTC.wav
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[AGENT][NEUTRAL] Calling APR, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Uh, yes, hi, um, I need to verify coverage on a patient.
[AGENT][POSITIVE] Sure, I can assist you with that. Can I have your name and a callback number?
[CUSTOMER][NEUTRAL] Uh, my name is [PII]. The phone number is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Could you provide me with the spelling of your name and the policy number?
[CUSTOMER][NEUTRAL] Uh [PII]
[CUSTOMER][NEUTRAL] And the policy number is 02286509 M like Mary L like Larry and number 8.
[AGENT][NEUTRAL] Thank you, [PII]. Could you verify that patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII] [PII].
[AGENT][NEUTRAL] And you're calling to verify benefits eligibility for what place of service?
[CUSTOMER][NEUTRAL] Um, it's for a specialist, um, office, and it's for, it's for an ultrasound.
[AGENT][NEUTRAL] So this member's policy covers the treatment received in the office which falls under the outpatient benefits of $500 per calendar day, and this is not a guaranteed benefits, just a disclaimer of the policy's coverage. The policies does not cover office visits itself, but the treatment received in the office is covered, [PII], and this policy became effective [PII] and it's currently active.
[CUSTOMER][NEUTRAL] OK, let me, what I, what I really need to find out, she does have a primary insurance, United. She has a deductible on coinsurance, and I wanted to know, uh, she is pregnant, she's coming for an ultrasound due to the pregnancy. I wanna know if you guys pick up the deductible on coinsurance, uh, from the primary.
[AGENT][NEUTRAL] Yes, this is a gap insurance that assists with deductible, co-pay and co-insurance. That is correct.
[CUSTOMER][NEUTRAL] You do pick up, OK, the.
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] What is the maximum benefit?
[AGENT][NEUTRAL] $500 per calendar day.
[CUSTOMER][NEUTRAL] Oh, so you cover up to $500 per, per visit.
[AGENT][POSITIVE] Per day, yes, that's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right. Can I get a reference number for the call?
[AGENT][NEUTRAL] We don't provide those [PII], however, you can use my name in today's date as a reference. It's S as [PII] and today's date.
[CUSTOMER][POSITIVE] Oh, OK. All right. Thank you.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. Have a good day. Bye bye.
[CUSTOMER][NEUTRAL] How much?
[CUSTOMER][NEUTRAL] You too.