AccountId: 011433970860
ContactId: 556531b1-58a7-41ab-b48f-fda37e84a57f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 147229 ms
Total Talk Time (AGENT): 70322 ms
Total Talk Time (CUSTOMER): 66516 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/556531b1-58a7-41ab-b48f-fda37e84a57f_20250123T15:50_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hey, good morning, uh, I'm calling from the provider's office. My name is [PII] and I just wanted to verify um benefits for our patients plan please.
[AGENT][NEUTRAL] Sure [PII], I can assist you with that. Can I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] Yep it's [PII] and I'm [PII].
[CUSTOMER][NEUTRAL] And the policy number.
[CUSTOMER][NEUTRAL] Would that be the the um benefit?
[CUSTOMER][NEUTRAL] Uh, certification number?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, it's 02229042 M like Mary, L like Larry 8.
[AGENT][NEUTRAL] Thank you [PII], could you verify that patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yep, [PII] and date of birth [PII].
[AGENT][POSITIVE] Thank you, so let me give you the correct policy number. Let me know when you're ready for it.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] I'm ready.
[AGENT][NEUTRAL] It is 256-433-1. That's 256-433-1. The policy has been effective since [PII] and is currently active. [PII], you're calling to verify benefits and eligibility. What are the place of service inpatient, outpatient, office visit?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] It'll be a specialist office and there and we would do an outpatient procedure in the office today.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] So the policy does not cover the office visit itself, however, the treatment received in the office is covered under the outpatient benefits.
[CUSTOMER][NEUTRAL] Got it under outpatient.
[AGENT][NEUTRAL] And the member's outpatient benefits?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It's still, I'm sorry, the outpatient benefit.
[AGENT][NEUTRAL] $7350 per calendar year and this is not a guaranteed benefits just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] OK perfect and no.
[AGENT][NEUTRAL] Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] Um, no authorizations required, right?
[AGENT][NEUTRAL] No, ma'am, this is a gap insurance.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Got it OK and is there a reference number for our call?
[AGENT][NEUTRAL] Don't provide those [PII], but you can feel free to use my name in today's date as a reference. It's [PII], and today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, got it thank you so much I appreciate your help.
[AGENT][POSITIVE] You're welcome thanks for calling APL. Have a good day. Goodbye.
[CUSTOMER][POSITIVE] You too thanks bye bye.