AccountId: 011433970860
ContactId: 5d9ca1f8-0ce8-45cb-b403-d668a741cd69
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 136880 ms
Total Talk Time (AGENT): 74700 ms
Total Talk Time (CUSTOMER): 52709 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/5d9ca1f8-0ce8-45cb-b403-d668a741cd69_20250221T16:09_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Is it another fax number?
[CUSTOMER][NEUTRAL] Yes, hi, my name is [PII]. I'm calling from Doctor [PII]'s office, and I'm calling because I need to see if a patient's active and has benefits for her plan.
[AGENT][NEUTRAL] OK, well I can help you with the eligibility and the benefits and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Contact number is [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number?
[CUSTOMER][NEUTRAL] 02337129 ML 8
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Um, patient's name is [PII] Male, [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. I am showing the policy is active. It's been effective since [PII]. And um what type of benefits did you want to go over?
[CUSTOMER][NEUTRAL] So she has a deductible. Her primary plan, any procedures rendered in the doctor's office will be subject to her deductible. So does this plan cover procedures rendered in the office?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Not her policy. Um, the policy doesn't have any in in-office setting coverage. Um, it's inpatient and outpatient, but she doesn't have like that office treatment router that will help with the treatment or physician office coverage.
[CUSTOMER][NEUTRAL] Well, not the physician, not the physician office coverage, just a
[CUSTOMER][NEUTRAL] Just for the procedure like such as a biopsy run in the doctor's office.
[AGENT][NEUTRAL] Right. Anything in the in-office setting this policy does not have coverage for.
[CUSTOMER][NEUTRAL] So in in in office would also be considered as outpatient so she doesn't have it.
[AGENT][NEUTRAL] She doesn't, right. She doesn't have any in-office specialist, physician, it has to be the emergency room, urgent care, surgery in the hospital outpatient facility, or surgery center, not office.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me have a reference number for the call.
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name [PII] First initial to my last name is [PII] and today's date.
[CUSTOMER][POSITIVE] OK thank you alright bye bye thanks bye bye thank you.
[AGENT][POSITIVE] You're welcome, [PII]. Thanks for calling APL bye bye.
[CUSTOMER][NEUTRAL] You