AccountId: 011433970860
ContactId: 6675badc-fc4d-4423-8fd9-179eff5aeab6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 165250 ms
Total Talk Time (AGENT): 94549 ms
Total Talk Time (CUSTOMER): 67682 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/11/6675badc-fc4d-4423-8fd9-179eff5aeab6_20250311T14:57_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII]. I'm calling from West Kendall BGYN. Um, I'm calling because I have a patient that has a policy with you guys and I would like to verify her benefits, please.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure, I could check those benefits for you. uh, [PII], first, uh, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure it's [PII]. I'm sorry, and you said your name is?
[AGENT][NEUTRAL] Uh, [PII]
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Mhm. And then did you have that policy number? Yes, hi, [PII].
[CUSTOMER][NEUTRAL] [PII]. Hi [PII].
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Policy number is 2556475.
[AGENT][NEUTRAL] OK, and then, uh, what was the name and date of birth for the insured please?
[CUSTOMER][NEUTRAL] Oh, [PII].
[AGENT][NEUTRAL] Do you have the date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that, [PII]. Uh, so this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays, uh, we we need to look at inpatient or outpatient benefits.
[CUSTOMER][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] Well, um, she's going to be having a procedure in office.
[AGENT][NEUTRAL] That
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, she has a $70 co-payment with her private insurance, so you guys will be picking this up?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Excuse me, yes, um, and of course I will let you know verification of coverage is not a guarantee of payment for claims, uh, so treatment received in office is covered, um, total outpatient benefit, uh, per calendar year is $8700 max, so we would, um, any, uh, yeah, co-pay, deductible or co-insurance, um, until it reaches that maximum per calendar year and if you give me one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Has she used any? OK, it's hard.
[AGENT][NEUTRAL] Yes, I will check to see. Give me just a moment. No, that's fine. Let's see. OK, so none has been used so far this year. She does have that full benefit amount.
[CUSTOMER][NEUTRAL] OK, all right, um.
[CUSTOMER][NEUTRAL] High full amount.
[CUSTOMER][NEUTRAL] All right perfect um do I get a reference number for this call or?
[AGENT][NEUTRAL] Sure, uh, it would just be my first name, last initial, and today's date. Uh, so my last initial is [PII] Was there anything else I could help you with, [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Nope, that will be all [PII] thank you so much.
[AGENT][POSITIVE] Alright, well, of course, thanks for calling [PII]. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] Bye bye bye bye.
[AGENT][POSITIVE] Thanks, bye bye.