AccountId: 011433970860
ContactId: 5ac97728-6623-448c-85d5-c4201626fd70
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 172710 ms
Total Talk Time (AGENT): 98881 ms
Total Talk Time (CUSTOMER): 62067 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/5ac97728-6623-448c-85d5-c4201626fd70_20250211T15:29_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, so my name is [PII]. I'm calling from Associates and Advanced Maternal fetal medicine. I need to get eligibility and benefits for mutual patients since this, this is the patients, um, gap insurance.
[AGENT][POSITIVE] OK, sure, I can assist you with the eligibility and benefits and I'm sorry, how, how do you spell your name? I'm sorry.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you and may I have a callback number just in case we get disconnected, Miss [PII].
[CUSTOMER][NEUTRAL] Of course [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] sorry I completely blacked out for a second.
[AGENT][NEUTRAL] OK. No problem. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Of course 02291433 M as in mom, L as in Larry 7.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] they've been paying everything at 100.
[AGENT][NEUTRAL] OK, may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Of course her name is [PII] and her date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you, Miss [PII]. All right, and before I give you any benefit information, I need to let you know that 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 and for the benefits.
[CUSTOMER][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] Of course.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] No
[AGENT][NEUTRAL] And this is considered an outpatient facility or is it considered an office?
[CUSTOMER][NEUTRAL] Outpatient facility? Well, a specialist office outpatient, it's a little bit of both.
[AGENT][NEUTRAL] OK, so um.
[AGENT][NEUTRAL] OK, alright.
[AGENT][NEUTRAL] Uh, so let me give you both of the benefits just in case, OK, and it looks like you're welcome. We have an outpatient maximum of 1500. Um, if it's an outpatient facility, then that will be the benefit 1500 for any service. If it's a specialist, we do not cover for the office visit, we only cover for procedures and the procedures are subject to that benefit maximum of 1500 per year.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Perfect. And lastly I just the reference number of this call please.
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will. Do you need the spelling of my name or any other information, Miss. [PII]?
[CUSTOMER][POSITIVE] No, that's it thank you so much.
[AGENT][POSITIVE] You're welcome and thank you for calling ATO have a good day.
[CUSTOMER][NEUTRAL] Likewise bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.