AccountId: 011433970860
ContactId: 52deea33-763d-4012-b92e-26df46b23e08
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 187259 ms
Total Talk Time (AGENT): 75444 ms
Total Talk Time (CUSTOMER): 55222 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/06/52deea33-763d-4012-b92e-26df46b23e08_20250606T14:37_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII]. I'm calling from Urology Specialty care. Just wanted to get some benefits for a patient.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I like to verify benefits for you, Ms. [PII], and what is the policy number, please?
[CUSTOMER][NEUTRAL] Policy number is, one second, sorry, 02216665ML8.
[AGENT][NEUTRAL] Thank you, ma'am. And verify um callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and the patient's name, date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Date of birth [PII].
[AGENT][NEUTRAL] OK, I'm showing his effective date is [PII]. He is active on the policy and what benefits are needing for this patient?
[CUSTOMER][NEUTRAL] Uh, specialist office visit if I can give you some codes just to make sure it's a covered service.
[AGENT][NEUTRAL] Well, under the policy, it doesn't cover office visits. Um, the patient has a rider that covers procedures in the office if it's for sickness or an injury, just not the visit itself.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. What are the codes?
[CUSTOMER][NEUTRAL] Codes are 51784.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 97032.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And 97,750.
[AGENT][NEUTRAL] OK. And do you have the diagnosis code?
[CUSTOMER][NEUTRAL] Yes, diagnosis code is N as in Nancy 39.3.
[AGENT][POSITIVE] OK, thank you ma'am give me one moment.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 02.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, uh, they are or could be covered on the policy as outpatient, um, not a guarantee of payment, just verification coverage. The patient has an outpatient benefit that pays up to $500 per calendar day.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK perfect can I get your name once again and a reference number?
[AGENT][NEUTRAL] Yes, ma'am. It's [PII], last initial [PII], and if you like, you may use my name um and today's date as reference.
[CUSTOMER][POSITIVE] Alright, sounds great thank you so much [PII] you have a great day.
[AGENT][POSITIVE] Uh, you too, Ms. [PII]. Thanks for calling APL. Bye.
[CUSTOMER][NEUTRAL] Bye.