AccountId: 011433970860
ContactId: 4a3f863e-825b-4a84-9567-b5d0e1ca2264
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 218119 ms
Total Talk Time (AGENT): 98322 ms
Total Talk Time (CUSTOMER): 71434 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/4a3f863e-825b-4a84-9567-b5d0e1ca2264_20250117T22:44_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, yes, ma'am. My name is [PII]. I'm calling from Texas Digestive specialist. I was calling to verify benefits for a patient.
[AGENT][POSITIVE] OK, sure, I can assist you with benefits, Miss [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, it's gonna be [PII].
[CUSTOMER][NEUTRAL] And I am at extension [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you Miss [PII]. May I have the patient's policy number?
[CUSTOMER][NEUTRAL] It's gonna be 018687667.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] This is for Ms. [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Mm, that's not [PII]. Can I get that number one more time?
[CUSTOMER][NEUTRAL] Sure, I have 01 018687667.
[AGENT][NEUTRAL] Policy number.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, let me try that one more now.
[CUSTOMER][NEUTRAL] OK
[AGENT][POSITIVE] OK, perfect. Thank you.
[AGENT][NEUTRAL] Alright, and what type of service is being rendered for benefits?
[CUSTOMER][NEUTRAL] So she will be coming in for an office visit. I know normally this isn't um an office visit like policy thing but I still have to call.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Oh, OK. Well, let me check and see if it's covered, and this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. And let's see, so this is one of our secondary supplemental plan to the major medical and we cover the office procedures or treatment, but we do not cover the office visit. So if there's any procedures or treatment in the office, that's gonna be subject to the outpatient maximum which is 2550 per covered person per calendar year.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] And uh you said 2550?
[AGENT][NEUTRAL] Uh yes.
[CUSTOMER][NEUTRAL] And has she accumulated anything as of right now?
[AGENT][NEUTRAL] I can check um.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, no, she has not used her benefits for today, um, as of today for [PII], so she still have the full amount available.
[CUSTOMER][POSITIVE] Alrighty awesome thank you so much for that and I'm so sorry I didn't get your name in the beginning.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] It's OK. My name is [PII]'s [PII].
[CUSTOMER][NEUTRAL] Thank you, Ms. So, and can I get a reference number for this please?
[AGENT][NEUTRAL] We don't have reference numbers you can use my name in today's date if you will.
[CUSTOMER][NEUTRAL] OK, no problem, and I'm sorry, I actually didn't ask, um, would you be able to give me an effective date for the per the policy?
[AGENT][POSITIVE] Oh sure, yes, let me get that for you one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Effective date on the policy is [PII] and it is active at the moment.
[CUSTOMER][POSITIVE] Awesome thank you so much, [PII].
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good day, Miss [PII].
[CUSTOMER][POSITIVE] You too thank you bye bye.
[AGENT][POSITIVE] Thank you. You're welcome. Bye-bye.