AccountId: 011433970860
ContactId: 46f40d99-30f2-4c36-afc6-de105b434e4a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 176520 ms
Total Talk Time (AGENT): 84073 ms
Total Talk Time (CUSTOMER): 50902 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/46f40d99-30f2-4c36-afc6-de105b434e4a_20250528T15:13_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII].
[AGENT][NEUTRAL] How can I help you?
[CUSTOMER][NEUTRAL] Hi, yes, I'm calling uh for a patient. I would like to know the benefits.
[AGENT][POSITIVE] OK, yeah, I can get those benefits for you. um, what was your name?
[CUSTOMER][NEUTRAL] My name is [PII] and I'm sorry, what's your name?
[AGENT][NEUTRAL] It's [PII] and [PII], can I get a good callback number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Um, yes, [PII].
[AGENT][POSITIVE] Thank you. And then do you have that?
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] The policy number, please?
[CUSTOMER][NEUTRAL] 02415324
[AGENT][NEUTRAL] OK and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] And the first name is [PII] The last name is [PII]
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] Perfect thank you so much for verifying all of that so this policy is active.
[AGENT][NEUTRAL] Effective date was [PII] and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays.
[AGENT][NEUTRAL] And we we needing to look at inpatient or outpatient benefits for this number?
[CUSTOMER][NEUTRAL] Out patient, patients coming for an MRI.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims.
[AGENT][NEUTRAL] So the outpatient benefit uh um it's on a per occurrence basis so it pays $500 per occurrence and again that goes towards co-pay, deductible and co-insurance.
[CUSTOMER][NEUTRAL] OK, have they made anything or it's about 500?
[AGENT][NEUTRAL] So it's going to be on a per occurrence basis. So for example it's whatever they're being seen for regarding this MRI that's going to be one, considered one occurrence.
[CUSTOMER][NEUTRAL] OK, OK. OK, but uh they have available 500, correct?
[AGENT][POSITIVE] Correct per occurrence that's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, perfect. All right, perfect. Let me have um the uh call reference number in your name.
[AGENT][NEUTRAL] Sure, reference number would just be my first name, last initial, and today's date and so my name is spelled K A R A. last initial is [PII] Was there anything else I could help you with?
[CUSTOMER][POSITIVE] No, that's it thank you so much.
[AGENT][POSITIVE] Of course, thanks for calling APL. Have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you.