AccountId: 011433970860
ContactId: 62cea8e7-7609-4498-9bd7-d5d1e2201e88
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 200619 ms
Total Talk Time (AGENT): 68433 ms
Total Talk Time (CUSTOMER): 75430 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/62cea8e7-7609-4498-9bd7-d5d1e2201e88_20250320T18:10_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APO. My name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Hi, [PII]. I'm calling because I should have a policy with you guys to the end of the month and I was trying to create my account but um it didn't find me, um, so that's why I was calling.
[AGENT][POSITIVE] OK, I'll be happy to assist. May I have your policy number please?
[CUSTOMER][NEUTRAL] Um, can I give you my social?
[AGENT][NEUTRAL] Oh, that'll be fine.
[CUSTOMER][NEUTRAL] OK, it's [PII].
[AGENT][NEUTRAL] And if you can verify your date of birth and email address.
[CUSTOMER][NEUTRAL] Sure, it's [PII]. [PII]. Uh, it should be my old email address of my job [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Please be advised the verification of coverage is not a guarantee of payment.
[AGENT][NEUTRAL] And is this gonna be for inpatient or outpatient?
[CUSTOMER][NEUTRAL] Um, for outpatient.
[AGENT][NEUTRAL] OK, so for outpatient for, um, so where would you have the treatment?
[CUSTOMER][NEUTRAL] Well, I, I don't know if my policy covers like co-pays, um, things like that that I could get reimbursed for.
[AGENT][NEUTRAL] But what type of treatment are you?
[CUSTOMER][NEUTRAL] It was for a mammogram and an ultrasound.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So that would fall under the, now, was it for just regular preventative or this was a diagnosis?
[CUSTOMER][POSITIVE] Correct, preventative.
[AGENT][NEUTRAL] Now, preventative is not covered under the policy.
[CUSTOMER][NEUTRAL] OK. The ultrasound wasn't preventative. I know they had to use another diagnosis. Would that then be covered with that?
[AGENT][NEUTRAL] Right. If it was not preventative, if it was like sickness, like something was a sickness diagnosis attached, then, OK, yeah. OK.
[CUSTOMER][POSITIVE] Yes, yes, yes, and the other transvaginal ultrasound, yes.
[AGENT][NEUTRAL] OK, then that will be covered under the outpatient up to that $1500 maximum.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, so you would just need to have, have you, have you had the procedure already?
[CUSTOMER][NEUTRAL] Yeah, yes.
[AGENT][NEUTRAL] OK, so you'll just need to submit your explanation of benefits from your primary insurance along with that diagnosis code from your medical provider.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, and since I wasn't, I'm, am I able to create my account since I was not able to because that's what I was trying to do um is it with the email address for my job?
[AGENT][NEUTRAL] Yes, that's the one that we have on file.
[CUSTOMER][NEUTRAL] Cause it wasn't letting me.
[CUSTOMER][POSITIVE] OK. All right. All [PII]. Thank you so much for your help.
[AGENT][NEUTRAL] OK, was there anything else I could assist with today?
[CUSTOMER][POSITIVE] No, that's it. Thank you.
[AGENT][POSITIVE] Thank you for calling APL you have a good day.