AccountId: 011433970860
ContactId: 3bc39f65-8019-457a-b4db-8a952baef9e9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 217130 ms
Total Talk Time (AGENT): 93523 ms
Total Talk Time (CUSTOMER): 77894 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/22/3bc39f65-8019-457a-b4db-8a952baef9e9_20250422T16:27_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, [PII]. This is [PII] from urology specialist group to check benefits.
[AGENT][POSITIVE] OK, I could take benefits for you. I'm so sorry, what did you say your name was?
[CUSTOMER][NEUTRAL] Oh, [PII] for you [PII].
[AGENT][NEUTRAL] I am so sorry if you wouldn't mind repeating that for me, it kind of cut out there at the beginning.
[CUSTOMER][NEUTRAL] Oh, [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII],
[CUSTOMER][NEUTRAL] I [PII]
[CUSTOMER][NEUTRAL] At Sunday.
[AGENT][POSITIVE] Got it. OK, thank you so much for that and then can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][POSITIVE] Yes, let me provide to you.
[CUSTOMER][NEUTRAL] I have 2,486,300.
[CUSTOMER][NEUTRAL] Let me see.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] And what was the name and date of birth for the member, please?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII] in [PII].
[AGENT][NEUTRAL] Perfect, thank you so much for verifying that. Uh, so this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays, and we really need to look at, uh, inpatient or outpatient benefits.
[CUSTOMER][NEUTRAL] Outpatient.
[AGENT][NEUTRAL] Outpatient, OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims. So his outpatient benefit is $5000 max per calendar year. If you'll give me one moment, I'll see if any of that has been used.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, none has been used so far this year.
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] Serial mat.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, allow me one moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, I have a question for you, um, [PII]. The office visits are covered or not?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Uh, let me check that for you. They are different on each policy. Bear with me just a moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so under this policy, office visits are not going to be covered.
[CUSTOMER][NEUTRAL] OK. Just to confirm, uh, the information, the, the effective date of the policy is [PII], no termination date. And you said the outpatient services are covered, um, up to $5000 and 0M.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And you said office visits are not covered.
[AGENT][POSITIVE] Correct.
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK, excellent. Do you have a reference number, [PII]?
[AGENT][NEUTRAL] That would, sure, that would just be my first name, last initial and today's date and so my name is spelled [PII], was there anything else I could help you with?
[CUSTOMER][POSITIVE] Yes, Dad. Thank you so much for your help.
[AGENT][POSITIVE] Of course, yeah, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.