AccountId: 011433970860
ContactId: 3be2d9d5-708d-4d86-9b75-0520b8730a45
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 184000 ms
Total Talk Time (AGENT): 87536 ms
Total Talk Time (CUSTOMER): 76590 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/3be2d9d5-708d-4d86-9b75-0520b8730a45_20250325T17:53_UTC.wav
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[AGENT][NEUTRAL] Contacting. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, yes, I'm calling for um.
[CUSTOMER][NEUTRAL] Sorry, specialist office visit as well as ultrasound done in the office?
[AGENT][NEUTRAL] OK, I can certainly look up those benefits, and with whom am I speaking, please?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] [PII], thank you. What's that policy number that we're looking at today?
[CUSTOMER][NEUTRAL] Sure it's 01626372 ML8.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] I appreciate that. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] [PII] uh.
[CUSTOMER][NEUTRAL] Hold on [PII].
[AGENT][POSITIVE] OK, thank you very much.
[AGENT][NEUTRAL] OK, so first of all, this is a group gap insurance that they received to their employer and every time they renew the group, they get a new uh policy number. So Viins uh most current policy which went into effect on [PII] is 0259.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 727-9 and that is active. Now, what we will do is we'll pick up the deductible, co-payment or co-insurance for treatment within the physician's office up to $3000 per calendar day. That is just a verification of benefits, not a guarantee of payment, but that does not include the um uh office visit co-pay.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] So the treatment is covered.
[AGENT][NEUTRAL] But the office visit is not.
[CUSTOMER][NEUTRAL] OK, and it's covered up to 3000, right?
[AGENT][NEUTRAL] Per calendar day, that is correct.
[CUSTOMER][NEUTRAL] Per calendar day, so per day like so if they have the ultrasound done in office today and then it's 3000 and like up the benefit up to and then again another 3000 tomorrow if they choose to do another ultrasound.
[AGENT][NEUTRAL] It
[AGENT][NEUTRAL] Mhm. Every single day.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK, alright, that's good coverage um.
[CUSTOMER][NEUTRAL] Let me see what else I need to ask if anything.
[CUSTOMER][NEUTRAL] I think that's it and when was the plan become active again or renewed the group? I don't know.
[AGENT][NEUTRAL] The plan, uh, [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, what was your name again? I'm sorry.
[AGENT][NEUTRAL] Yes, my name is [PII]. The first letter of my last name is [PII], and we're gonna use that in today's date as a reference. [PII], is there anything else at all I could tell you about the secondary or gap insurance?
[CUSTOMER][NEUTRAL] It, uh, no, you were you're referring to the gap insurance of the information you gave me now, right?
[AGENT][POSITIVE] Right, yes, that's correct. Yeah, this is GA Insurance, so we're, we're not major medical, we're meant to compliment her major medical.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Like secondary gaps.
[CUSTOMER][NEUTRAL] OK, all right.
[CUSTOMER][POSITIVE] Alright, um, no, that's all I need thank you for your help.
[AGENT][POSITIVE] OK, well thank you for contacting you have a good day.