AccountId: 011433970860
ContactId: 6ad4a7ed-dfc9-4c3b-b13f-a5aeb2405632
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 190130 ms
Total Talk Time (AGENT): 76514 ms
Total Talk Time (CUSTOMER): 68326 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/11/6ad4a7ed-dfc9-4c3b-b13f-a5aeb2405632_20250311T20:36_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, good afternoon, [PII]. My name is [PII]. I'm calling from um a provider's office. I was calling to verify um the balance for a patient, uh, for a patient's gap insurance.
[AGENT][NEUTRAL] OK, uh, let's take a look, [PII], is it in it's in regards to a claim that was submitted on their behalf?
[CUSTOMER][NEUTRAL] No, we have not yet submitted the claim. The patient has not been seen yet. They will be getting seen this week, but they wanted to make sure that the gap insurance is gonna cover the co-payment of their.
[AGENT][NEUTRAL] OK, gotcha, gotcha. What's the policy number?
[CUSTOMER][NEUTRAL] Exam.
[CUSTOMER][NEUTRAL] The policy number I have is 02548739.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And then [PII], what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] date of birth [PII].
[AGENT][POSITIVE] Thank you so much. So the patient's plan is active. The effective date on this is [PII], and are they being seen for like an office visit? What is?
[CUSTOMER][NEUTRAL] Yes, they're coming in for an office visit.
[AGENT][NEUTRAL] Alright, let me see if the member's plan covers any sort of physician office visit fee.
[CUSTOMER][NEUTRAL] So they're actually coming in for a visit for 2 MRIs and we're an imaging facility, so she's coming in for radiological imaging.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So it looks like diagnostic testing performed in an outpatient facility or um physician's office is covered under their outpatient benefits. The outpatient benefits on this plan looks like for the.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] This plan is per calendar day which is $300 max.
[CUSTOMER][NEUTRAL] $300.
[CUSTOMER][NEUTRAL] Max per day.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][NEUTRAL] And may I have a reference number please?
[AGENT][NEUTRAL] Yeah, absolutely. Call reference is my name with my last initials in today's date. My name again is [PII], which is [PII] and my last initial is [PII].
[CUSTOMER][NEUTRAL] OK, and today's date?
[AGENT][NEUTRAL] Mhm, yes, ma'am.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yep.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] Is there anything else, [PII]?
[CUSTOMER][POSITIVE] No, you've helped me with everything thank you so much for your time today.
[AGENT][POSITIVE] Have a good day.
[CUSTOMER][POSITIVE] Thank you you too.
[AGENT][NEUTRAL] Bye bye.