AccountId: 011433970860
ContactId: 4b6e703d-0fc0-473a-9d7f-fa22d2cc45a6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 204639 ms
Total Talk Time (AGENT): 94025 ms
Total Talk Time (CUSTOMER): 53473 ms
Interruptions: 0
Overall Sentiment: AGENT=2.2, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/18/4b6e703d-0fc0-473a-9d7f-fa22d2cc45a6_20250618T17:15_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] calling from Steinberg Diagnostic. I was just calling to verify benefits and eligibility for a member.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with both the benefits and eligibility. And may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Alright, and may I have the um
[AGENT][NEUTRAL] I'm sorry, for my notes, can you spell your first name for me, please, and then provide the member's policy number?
[CUSTOMER][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] Policy number is 02565106.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And [PII], can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment, and I am showing the policy is active. It's been effective since [PII].
[CUSTOMER][NEUTRAL] You said it was active since [PII]?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Yes, ma'am, of [PII].
[CUSTOMER][POSITIVE] Oh perfect.
[AGENT][NEUTRAL] And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I just wanted to confirm benefits it's for an ultrasound and a mammogram diagnostic. I do have those CPT codes.
[AGENT][NEUTRAL] Ultrasound and mammogram. OK, so outpatient diagnostic testing?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] So under outpatient, the policy will pay up to $3000 per person per calendar year.
[AGENT][NEUTRAL] Um, and that does include diagnostic testing in an outpatient facility, um, or I'm sorry, outpatient hospital facility, an MRI facility, physician's office, specialist office, independent lab, um, so it would all be out of that 6000 per year, I'm sorry, 3000 per year.
[AGENT][NEUTRAL] Did you want me to see if any of the 3000 has been used?
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And so far for [PII], she has not used any of the balance.
[CUSTOMER][NEUTRAL] Perfect and then can I also have a call reference number?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date, and the first initial to my last name is [PII].
[CUSTOMER][POSITIVE] Perfect. And then for the patients, um, effective dates there was no term date, correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Perfect thank you so much for your help.
[AGENT][POSITIVE] You're welcome, [PII]. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, that was all.
[AGENT][POSITIVE] All right, thanks for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] You as well.
[AGENT][POSITIVE] Thank you, bye bye.