AccountId: 011433970860
ContactId: 3e44291e-0598-411a-beb4-af58c32b551d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 167309 ms
Total Talk Time (AGENT): 90008 ms
Total Talk Time (CUSTOMER): 81108 ms
Interruptions: 2
Overall Sentiment: AGENT=1.8, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/3e44291e-0598-411a-beb4-af58c32b551d_20250121T20:19_UTC.wav
--------------------------------------------
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, I need to verify eligibility and benefits for a patient.
[AGENT][POSITIVE] OK, I'll be more than happy to help you with the eligibility and benefits. And may I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, my first name's [PII].
[CUSTOMER][NEUTRAL] The best number is [PII].
[AGENT][NEUTRAL] Thank you for that, and [PII], may I have the member's policy number?
[CUSTOMER][NEUTRAL] It is 01819428 M as in Mary, L as in Lima 8.
[AGENT][NEUTRAL] Thank you for that. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] [PII] [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 the policy is active. It's been effective since [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what type of benefits, um, did you need to go over today?
[CUSTOMER][NEUTRAL] Um, mental health.
[CUSTOMER][POSITIVE] It's right.
[AGENT][NEUTRAL] OK, would it be as an outpatient or inpatient?
[CUSTOMER][NEUTRAL] Outpatient um doctor's office.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So again, just for the call, all the information provided is a verification of benefits, not a guarantee of payment. So the outpatient max for the calendar day for this policy is $1000.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Right
[AGENT][NEUTRAL] Now, that does include um or outpatient treatment in a mental or emotional disorder in a hospital outpatient facility, but she also has the office treatment rider.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] All
[CUSTOMER][NEUTRAL] The weekend I see.
[AGENT][NEUTRAL] So any treatment that is done in the office as long as it's not cosmetic, um, should be covered up to that $1000 per day.
[CUSTOMER][NEUTRAL] How about you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And so I'm sure there's probably somebody you out of there.
[AGENT][POSITIVE] All righty. Was there anything else I could assist you with today?
[CUSTOMER][NEUTRAL] Um, are there any deductibles or out of pockets or anything that applies to this policy for this coverage?
[AGENT][NEUTRAL] No, ma'am, not for this policy.
[CUSTOMER][NEUTRAL] Or just the 1000.
[CUSTOMER][NEUTRAL] OK, and if I could get your name and a reference number for this call, I think that was it.
[AGENT][NEUTRAL] Sure, my name is [PII].
[AGENT][NEUTRAL] And there's no call reference number, but you can use my name and today's date.
[CUSTOMER][POSITIVE] OK, thank you so much I appreciate all your help.
[AGENT][POSITIVE] You're very welcome and thanks for calling APL. I hope you have a great day as well.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][POSITIVE] Thank you. Bye bye.