AccountId: 011433970860
ContactId: 4438b6d2-7748-4487-84fe-21192da56227
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 180220 ms
Total Talk Time (AGENT): 67003 ms
Total Talk Time (CUSTOMER): 107259 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/4438b6d2-7748-4487-84fe-21192da56227_20250305T20:55_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from the office of Doctor [PII]. I need to verify, uh, benefits and liability for one of our patients.
[AGENT][NEUTRAL] OK, I can verify benefits and eligibility for you and I apologize, your name is again?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And what is the policy number, please?
[CUSTOMER][NEUTRAL] 02099835.
[CUSTOMER][NEUTRAL] What
[AGENT][NEUTRAL] OK, thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] OK. And verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] Her name is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. I've shown her effective date is [PII]. She is active on the policy and what benefits are needing for this patient?
[CUSTOMER][NEUTRAL] She's going to have surgery outpatient office setting specialist, and her primary, which is United Healthcare, has a $5000 deductible.
[CUSTOMER][NEUTRAL] So she told me that you guys cover the deductible.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, not for procedures in office. Uh, under this patient's policy, office visits or procedures in office are not covered.
[CUSTOMER][NEUTRAL] OK, so procedures.
[CUSTOMER][NEUTRAL] In office are not covered by your
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Are not cover. Are you a gap insurance?
[AGENT][NEUTRAL] Uh, we're secondary supplemental.
[CUSTOMER][NEUTRAL] Secondary supplemental.
[CUSTOMER][NEUTRAL] And you guys do not cover in office procedure. All you cover is hospital?
[AGENT][NEUTRAL] Outpatient or in hospitals, outpatient be in the ER, urgent care, ambulatory surgery center, MRI or imaging center.
[CUSTOMER][NEUTRAL] Oh, but not office OK office outpatient, I mean.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Hospital.
[CUSTOMER][NEUTRAL] Outpatient emergency whatever but not in office procedure.
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK, perfect. Thank you so much.
[AGENT][NEUTRAL] You're welcome. Is there anything else I can assist you with today, Ms. [PII]?
[CUSTOMER][NEUTRAL] No, that's it. Uh, can I have your name and a reference number?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, my name is [PII], and we don't give reference numbers, but if you like, you may use my name in today's date.
[CUSTOMER][POSITIVE] OK, today's date, perfect, thank you.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. Bye.
[CUSTOMER][NEUTRAL] Bye bye.