AccountId: 011433970860
ContactId: 5f417830-d085-4ad0-a055-d6ff6368da4b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 255529 ms
Total Talk Time (AGENT): 99310 ms
Total Talk Time (CUSTOMER): 126541 ms
Interruptions: 5
Overall Sentiment: AGENT=2.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/09/5f417830-d085-4ad0-a055-d6ff6368da4b_20250409T17:07_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I'm [PII] calling from provider office to checking for mental health, office visit, outpatient eligibility and benefits.
[AGENT][POSITIVE] OK, well, I'll be more than happy to assist you with the mental health benefits and from my notes, can you spell your first name for me, please, and provide a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] Yes. And then my first name, [PII].
[CUSTOMER][NEUTRAL] And the last name initial [PII].
[AGENT][NEUTRAL] OK, and a good contact number in case we're disconnected and the policy number.
[CUSTOMER][NEUTRAL] OK, and it's the contact number in case we're just
[CUSTOMER][NEUTRAL] Yes, sir. The contact number, [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And the policy number?
[CUSTOMER][NEUTRAL] Yes, the policy number is 016.
[CUSTOMER][NEUTRAL] 22812
[CUSTOMER][NEUTRAL] M as in Mike, L as in Lima, 8.
[AGENT][POSITIVE] 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] OK.
[CUSTOMER][NEUTRAL] Can you verify the
[CUSTOMER][NEUTRAL] [PII], date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And I am showing the policy is active. It's been effective since [PII].
[CUSTOMER][NEUTRAL] and all the information provided is the verification.
[CUSTOMER][NEUTRAL] And I am on the
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And for the outpatient benefit, it is up to $500 per calendar day.
[CUSTOMER][NEUTRAL] And the outpatient benefit is up to $500.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And would this be a like a, is it a, you said it is an outpatient facility, correct?
[CUSTOMER][NEUTRAL] And would this be in a like a
[CUSTOMER][NEUTRAL] that you said.
[CUSTOMER][NEUTRAL] Yes, outpatient office and tele visit.
[AGENT][NEUTRAL] OK, so they also have the, I just want to make sure because they also have the office treatment rider. So depending on how the coding comes over to us, um, the treatment in the office could still be covered up to that $500 per day.
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] So depending on
[CUSTOMER][NEUTRAL] Over to
[CUSTOMER][NEUTRAL] In the office
[CUSTOMER][NEUTRAL] To be covered up to that 500.
[CUSTOMER][NEUTRAL] $500 per day, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Co
[CUSTOMER][NEUTRAL] OK. Uh, is there any co-pay, co-insurance, or deductible?
[AGENT][NEUTRAL] Um, not for this policy. This is their secondary insurance, so we apply to the co-pay, deductible and co-insurance after primary.
[CUSTOMER][NEUTRAL] The 2nd 3 insurance so we.
[CUSTOMER][NEUTRAL] Copay deductible and car insurance after primary.
[CUSTOMER][NEUTRAL] Uh, yeah, it's, uh, do you covered, co-pay, co-insurance, or deductible?
[AGENT][NEUTRAL] So we are 2nd to the members AMed insurance. AvMed applies charges the co-pay, the deductible. We help pay it.
[CUSTOMER][NEUTRAL] So we are the 2nd member.
[CUSTOMER][NEUTRAL] a
[CUSTOMER][NEUTRAL] Is the copay the deductible we help pay.
[CUSTOMER][NEUTRAL] OK. So you covered primary responsibility, right?
[AGENT][NEUTRAL] We cover the co-pay, deductible and co-insurance of covered charges after primary insurance.
[CUSTOMER][NEUTRAL] We cover
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Home insurance of coverage charges.
[CUSTOMER][POSITIVE] OK. Thank you. Thank you, [PII].
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] May I know the reference number, please?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] Reference number but you can my name and today's date the first initial.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome. Was there anything else I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Anything else I can assist you with today? No thank you.
[AGENT][POSITIVE] You're welcome and thanks for calling APL. I hope you have a good day.
[CUSTOMER][POSITIVE] Thanks for calling I hope you have a good day. Thank you, bye.
[AGENT][POSITIVE] You're welcome bye bye.
[CUSTOMER][NEUTRAL] Bye bye.