AccountId: 011433970860
ContactId: 3f5ba06a-4db8-4490-8946-b34d8e37bba3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 125480 ms
Total Talk Time (AGENT): 42797 ms
Total Talk Time (CUSTOMER): 75818 ms
Interruptions: 2
Overall Sentiment: AGENT=1.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/3f5ba06a-4db8-4490-8946-b34d8e37bba3_20250624T15:03_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Yes, hi, good morning. I'm calling from a provider's office, um, to verify if this secondary insurance picks up the patient's copay for today's visit.
[AGENT][POSITIVE] I'd be happy to assist with benefits and eligibility. May I have your first name please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] And so being, if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] [PII], it's a direct line.
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] It is um 02611551.
[AGENT][NEUTRAL] Patient's name and date of birth.
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Uh, [PII] and it's [PII].
[AGENT][NEUTRAL] Thank you for that information. Please be advised the verification of coverage is not a guarantee of payment. I do show the policy is currently active. Effective date is [PII]. Um, now where did you say treatment would take place?
[CUSTOMER][NEUTRAL] Mm no, how can I help you?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Um, low ophthalmology, it's a specialist office visit. Um, you have to call just to see if anyone has cancer.
[AGENT][NEUTRAL] OK, now only the treatment and procedures at the visit will be covered under the outpatient benefit of $6500 per calendar year.
[CUSTOMER][NEUTRAL] We just don't have a way of tracking.
[CUSTOMER][NEUTRAL] OK, let me see what he's coming in for, uh, yeah, he's coming in for a retina evaluation.
[AGENT][NEUTRAL] Do you have that CPT code?
[CUSTOMER][NEUTRAL] Let me see, yes, um, let me see, it's gonna be um 92002 and 92004.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEGATIVE] Uh oh shit.
[CUSTOMER][NEUTRAL] Huh?
[CUSTOMER][NEUTRAL] No no
[AGENT][NEUTRAL] OK, those would be covered, yeah.
[CUSTOMER][POSITIVE] Yeah, you guys pick up the, the copay, OK, perfect. OK, thank you so much, that's all I needed to know.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Alright, thanks for calling ACL. You have a good day.
[CUSTOMER][POSITIVE] Thank you you too bye.
[AGENT][NEUTRAL] Bye bye.