AccountId: 011433970860
ContactId: 4d5976ee-4a53-43ce-9b8e-45a5d725d4fd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 260980 ms
Total Talk Time (AGENT): 107430 ms
Total Talk Time (CUSTOMER): 73938 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/4d5976ee-4a53-43ce-9b8e-45a5d725d4fd_20250403T18:10_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I'm calling from urology specialty care calling to verify patients benefits.
[AGENT][NEUTRAL] OK, thank you, um, and we can help you with that information so this is a specialist office?
[CUSTOMER][NEUTRAL] Yes it is.
[AGENT][NEUTRAL] All right, and your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and what's the policy number and a good phone number in case we're disconnected, [PII]?
[CUSTOMER][NEUTRAL] Phone number [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And then the member ID is 1067624.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] First name [PII] Last name [PII] Date of birth [PII].
[AGENT][NEUTRAL] OK, thank you for that information showing an effective date of [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And I show the policy is active at this time and we're looking for.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see, you said.
[CUSTOMER][NEUTRAL] Office visits and in office procedures please.
[AGENT][NEUTRAL] So I show that the policy, give me a second.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Um, I have the benefit information for you. I show that the policy maximum.
[AGENT][NEUTRAL] Benefit for treatment in the office is up to $25 per visit.
[AGENT][NEUTRAL] And let me give you the number of days.
[CUSTOMER][NEUTRAL] 25 per visit for the office visit?
[AGENT][POSITIVE] Yeah, the max, yep.
[AGENT][NEUTRAL] Yes, and that includes the physician co-pay and any treatment in the office. The max is 25 under this policy. Give me a second.
[AGENT][NEUTRAL] Up to 25 per visit, maximum of 4 visits per covered person per calendar year, and a maximum of 8 visits.
[AGENT][NEUTRAL] Per calendar year for all covered persons combined.
[AGENT][NEUTRAL] And for [PII].
[CUSTOMER][NEUTRAL] How many visits has he used?
[AGENT][NEUTRAL] Mhm I'm checking that for you now.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I'm not showing any of the visits you used this year.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Um, OK, and you said it covers $25 for the office visit and another $25 for in-off procedures?
[AGENT][NEUTRAL] Incorrect, so yeah, it's, it's up to $25 per visit. So that's gonna include the physician's fee and any treatment in the office. The max is $25 per visit.
[CUSTOMER][NEUTRAL] That's all
[CUSTOMER][NEUTRAL] OK, go ahead.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 25
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, got it and then he would have to pay the difference?
[AGENT][NEUTRAL] We do not determine patients responsibility. We can just tell you what the policy benefit is, which is up to 25 per visit.
[CUSTOMER][NEUTRAL] OK, can you hold for me one second please?
[AGENT][NEUTRAL] Sure, sure.
[CUSTOMER][POSITIVE] Thank you very much.
[CUSTOMER][NEUTRAL] OK, may I have your name and a reference number please?
[AGENT][NEUTRAL] Mhm. You'll use my name in today's date as your reference. [PII] First initial of my last name is [PII] and [PII], did you have any other questions we can help out with today?
[CUSTOMER][POSITIVE] No, that's it. Thank you very much for your help. You have a wonderful day.
[AGENT][NEUTRAL] You
[AGENT][POSITIVE] You're welcome thanks for calling APL have a good day.
[CUSTOMER][NEUTRAL] And