AccountId: 011433970860
ContactId: 5e7b1ef0-6d15-4247-aeda-d6e6607d1a68
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 180000 ms
Total Talk Time (AGENT): 78973 ms
Total Talk Time (CUSTOMER): 80839 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/5e7b1ef0-6d15-4247-aeda-d6e6607d1a68_20250214T16:54_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, um, I'm calling from a provider's office to verify, uh, coverage on a member, please.
[AGENT][NEUTRAL] OK, I can verify benefits for you and your name is?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And Ms. [PII], what is that policy number, please?
[CUSTOMER][NEUTRAL] The policy number is
[CUSTOMER][NEUTRAL] 018.
[CUSTOMER][NEUTRAL] 873.
[CUSTOMER][NEUTRAL] 89 M as in Mary, L as in Laura number 8.
[AGENT][NEUTRAL] Thank you. And do you have a call, a callback number after the call is, um, if the call is dropped? Sorry.
[CUSTOMER][NEUTRAL] Mhm, it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. And verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] It's [PII], [PII].
[AGENT][NEUTRAL] OK, I'm showing his effective date is [PII]. He is active on the policy. And what benefits are you needing for this patient?
[CUSTOMER][NEUTRAL] I need I need to see if it's covered uh for an outpatient. He's going to do an outpatient colonoscopy in uh in the specialist office. I wanted to know if you, if we could use the benefits for that.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] One moment. And is this colonoscopy a screening or is it for uh diagnostic?
[CUSTOMER][NEUTRAL] It's diagnostic.
[AGENT][NEUTRAL] OK, um, the patient does have a writer that covers treatment performed in office as outpatient, not a guarantee of payment, just a verification of coverage. With this policy, we are secondary. We help with primary insurance deductible, co-pay, and or co-insurance, and he has an outpatient benefit that pays up to $1000 per calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 1000 for a calendar year and has he used anything?
[AGENT][NEUTRAL] Uh, no, ma'am. I don't show any many use, so it's available.
[CUSTOMER][NEUTRAL] Mhm, OK.
[CUSTOMER][NEUTRAL] OK, and you said he, it will be, it will be OK for him to use it, uh, when doing it in the in the office, right? Surgical in the office and procedures in office.
[AGENT][NEUTRAL] Yes, ma'am. He has a writer that covers uh procedures in office. Yes, ma'am.
[CUSTOMER][POSITIVE] Perfect, thank you so much for that information. You said your name is [PII]?
[AGENT][NEUTRAL] Uh yes, ma'am, last initial [PII]
[CUSTOMER][NEUTRAL] [PII], is there a reference number for the call?
[AGENT][NEUTRAL] Uh, we don't give reference numbers. You may use my name in today's date.
[CUSTOMER][POSITIVE] Perfect. OK, [PII], thank you so much. I really appreciate your help. Have a good rest of your day.
[AGENT][POSITIVE] Alright, you too, and thanks for calling [PII]. Bye.
[CUSTOMER][POSITIVE] Thank you thank you bye bye.