AccountId: 011433970860
ContactId: 3cb91592-af36-41ff-a60b-ad97d55947e6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 156240 ms
Total Talk Time (AGENT): 85279 ms
Total Talk Time (CUSTOMER): 39906 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/3cb91592-af36-41ff-a60b-ad97d55947e6_20250305T21:21_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][POSITIVE] Hello ma'am. I wanna know the benefits for one of our patients.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the benefits, and may I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the phone number is [PII].
[AGENT][NEUTRAL] Thank you for that. And [PII], may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yes. So it's 186-8817.
[AGENT][POSITIVE] Thank you for that. Hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Thank you for that. And all the information provided is a verification of benefits, not a guarantee of payment. I am showing that the policy is active. It's been effective since [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] Like PCP office visit?
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] The copay.
[AGENT][NEUTRAL] So the policy for outpatient will pay up to $2550 per person per calendar year.
[AGENT][NEUTRAL] Now, in terms of like a facility charge or place of service charge, there's no in-office coverage, but the insured does have the office treatment rider in which the treatment done in the office could be covered um up to um whatever they have available from their max. Did you want me to see if any has been used?
[CUSTOMER][NEUTRAL] Um, yes, ma'am.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And she has not used any of the benefits for this year yet.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, was there anything else I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Um, also, how about the mammograms and ultrasounds done here in, in the office?
[AGENT][NEUTRAL] It would be the same, um, it would be considered treatment.
[CUSTOMER][NEUTRAL] OK, ma'am.
[CUSTOMER][NEUTRAL] Then that'll be it. Um, do you have a reference number?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] OK, ma'am.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Alright. You're welcome. Thanks for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] Likewise. Bye-bye.
[AGENT][POSITIVE] Thank you bye bye.