AccountId: 011433970860
ContactId: 5a4bbf2a-6bc5-48fc-9f62-b1089e062589
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 246929 ms
Total Talk Time (AGENT): 121805 ms
Total Talk Time (CUSTOMER): 51999 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/5a4bbf2a-6bc5-48fc-9f62-b1089e062589_20250320T13:16_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] I'm calling to verify, uh, eligibility and benefits.
[AGENT][NEUTRAL] OK, sure, I can assist you with the eligibility and benefits, and may I have your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Miss [PII], may I have the name of the facility you're calling from for my notation?
[CUSTOMER][NEUTRAL] Virginia fertility and IVF.
[AGENT][NEUTRAL] OK, thank you and may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] I have 023-31430.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, you say you need eligibility and benefits. Um, what type of service is being rendered for benefits?
[CUSTOMER][NEUTRAL] Um, she's coming to us as a new patient.
[CUSTOMER][NEUTRAL] And we are going to be testing for infertility.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, and so this is gonna be considered an outpatient facility or office?
[CUSTOMER][NEUTRAL] It's the office.
[AGENT][NEUTRAL] All right. Let me go ahead and give you benefits and this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. We have an effective date of [PII]. It is active at the moment and this is one of our secondary supplemental plans to the major medical.
[AGENT][NEUTRAL] And let's see.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, we do cover for testing. Um, let me check and see if we covered the office in one moment.
[CUSTOMER][NEUTRAL] I think [PII] took it and then I just used it while it was in the middle.
[AGENT][NEUTRAL] Gonna be one more minute. I'm waiting on the documents, OK? One moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, so this one only has the office treatment providers, so office visits are not gonna be covered. We only cover um the treatments or procedure done in office, which is subject to the outpatient maximum of 1500 per covered person per calendar year.
[CUSTOMER][NEUTRAL] So you say you cover treatment. What does that entail?
[AGENT][NEUTRAL] Testing. We cover treatment, testing, any procedures done in the office basically. Mhm yes. Mhm. We just don't cover the co-payment for the visit itself.
[CUSTOMER][NEUTRAL] Testing only OK I see.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, OK, and what was your name again?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] My name is [PII]. Is there anything else I can help you with today, Ms. [PII]?
[CUSTOMER][NEUTRAL] No ma'am, just a reference number.
[AGENT][NEUTRAL] Oh, we don't have reference numbers. You can use my name and today please.
[CUSTOMER][POSITIVE] OK, fair enough, thank you.
[AGENT][POSITIVE] You're welcome and thank you for calling HTO. Have a good day, [PII].
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][POSITIVE] Thank you. Bye-bye.