AccountId: 011433970860
ContactId: 5a26efd8-ad04-47b2-af7f-9ac5fe59300c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 160449 ms
Total Talk Time (AGENT): 104427 ms
Total Talk Time (CUSTOMER): 44705 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/5a26efd8-ad04-47b2-af7f-9ac5fe59300c_20250417T19:19_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes. Hi, I'm calling from Doctor [PII]'s office. I have a patient that I would like to verify benefits for, please.
[AGENT][NEUTRAL] Yeah, I can check those benefits for you. Uh, what was your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], can I get a good callback number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Uh yes, I do. It is um
[CUSTOMER][NEUTRAL] 01672566 M as in Mary, L as in Larry 8.
[AGENT][NEUTRAL] OK and uh what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] Yes, her name is [PII]. Her date of birth is [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that. Uh, so this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays, and we really need to look at uh inpatient or outpatient benefits.
[CUSTOMER][NEUTRAL] It's an outpatient procedure in the office.
[AGENT][NEUTRAL] OK, OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims so that outpatient benefit is $1250 per calendar year and if you'll give me one moment I'll see if any of that has been used. Oh sure.
[CUSTOMER][NEUTRAL] Can you repeat? I'm so sorry, can you repeat that? Can you repeat the number?
[AGENT][NEUTRAL] Yes, of course that's $1250 per calendar year and then I'll I'll go ahead and check to see if any of that has been used.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] OK, so none has been used so far this year, uh, and I'm sorry you did say that this was a, um, procedure in office, correct?
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] OK, so and then I will also let you know office visits under this policy are not covered uh however treatment received in office is, so if she's receiving a procedure that should be perfectly fine. The only thing that wouldn't be covered is, you know, she was just getting like a consultation or something like that.
[CUSTOMER][NEUTRAL] OK, OK, OK, perfect. Can I get a reference number if you don't mind?
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Yeah, that would just be my first name, last initial, and today's date, and so my name is spelled [PII] Was there anything else I could help you with, [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, that would be all. Thank you so much.
[AGENT][POSITIVE] Alright, yeah, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] OK you too bye.
[AGENT][POSITIVE] Thank you bye bye.