AccountId: 011433970860
ContactId: 6bde142e-819d-426c-8e05-d1ddc8c1a87b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 143039 ms
Total Talk Time (AGENT): 52633 ms
Total Talk Time (CUSTOMER): 55242 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/6bde142e-819d-426c-8e05-d1ddc8c1a87b_20250320T19:27_UTC.wav
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[AGENT][NEUTRAL] For calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Um, yes, I'm meaning to verify benefits and eligibility for uh mental health or behavioral help.
[AGENT][POSITIVE] I'd be happy to assist with benefits and eligibility. May I have your first name please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And [PII], if I can get a good call back number for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] Um, the
[CUSTOMER][NEUTRAL] Oh, I know it's on there. It is um 02595355.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] and date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that information. Please be advised the verification of coverage is not a guarantee of payment. I do show the policy is currently active. Effective date is [PII]. And where will treatment take place?
[CUSTOMER][NEUTRAL] Office setting outpatient.
[AGENT][NEUTRAL] OK, I do show that would fall under the outpatient calendar year maximum of $6800. Patient does have a outpatient.
[AGENT][NEUTRAL] Deductible of 1500. Let me see if he's met any of that.
[AGENT][NEUTRAL] No, he hasn't met any of the deductible.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is any prior authorization required?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] And there's no um you don't necessarily do anything with in or out of network correct?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the claims for uh mental health, are they the same as the [PII] 248,950?
[CUSTOMER][NEUTRAL] Oklahoma [PII].
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, and may I have a reference name or number for this call, please?
[AGENT][NEUTRAL] Reference is just my name [PII] last initial S as in [PII], and the date and time of the call. Was there anything else I could assist with today?
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] No ma'am, that is it.
[AGENT][POSITIVE] Thank you for calling APL you have a good day.
[CUSTOMER][POSITIVE] Thank you bye.