AccountId: 011433970860
ContactId: 4344b05a-3d44-4054-99c4-bcc22a842aa4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 184839 ms
Total Talk Time (AGENT): 73216 ms
Total Talk Time (CUSTOMER): 70336 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/17/4344b05a-3d44-4054-99c4-bcc22a842aa4_20250617T17:52_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] and I'm calling with Novo Health Heart and Vascular, and I'm trying to verify some insurance and to verify if we are in network with this policy.
[AGENT][NEUTRAL] I'm sure, [PII], I can assist you with benefits. Um, first, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] 02605970
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII]. Date of birth [PII].
[AGENT][NEUTRAL] OK, thank you and just let me advise you that verification of coverage does not guarantee payment of claims. Um, I'm showing the effective date on this policy was [PII] and the policy is still active. Um, is this for an office visit?
[CUSTOMER][NEUTRAL] Yes it is.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] His benefits are coming up. OK.
[CUSTOMER][NEUTRAL] They can either one.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And as far as the network go, there is no network under this policy. We work with all providers.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK, let's see for office visits.
[CUSTOMER][NEUTRAL] And there was
[CUSTOMER][NEUTRAL] So I can
[CUSTOMER][NEUTRAL] 3
[AGENT][NEUTRAL] OK, for office visits, we cover up to $75 per visit and he gets 6 visits per calendar year.
[CUSTOMER][NEUTRAL] Yeah, yeah, so the one I have an operation.
[CUSTOMER][NEUTRAL] OK, so it it doesn't necessarily have a network?
[AGENT][NEUTRAL] No, ma'am. It doesn't.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK, so it covers up to $75 per visit, 6 office visits per year, and then if there's any testing, does he need um pre-authorization?
[AGENT][NEUTRAL] Um, no, there's no authorization required.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, and I just assigned.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right thank you so much I appreciate it.
[AGENT][NEUTRAL] OK. Is there anything else I can assist you with?
[CUSTOMER][POSITIVE] That's it thank you so much and uh actually one quick question so that the office visit, it is for a cardiologist?
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Does that make a difference?
[AGENT][NEUTRAL] No, ma'am. It doesn't. It's for all the specialists or primary care, or not primary care but um basic care.
[CUSTOMER][NEUTRAL] Of
[CUSTOMER][POSITIVE] All right thank you so much.
[AGENT][POSITIVE] OK, thank you again for calling APL. You have a great day. Mm bye.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you.