AccountId: 011433970860
ContactId: 6ddaf0fc-457e-48f1-88c8-7e808c132481
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 295700 ms
Total Talk Time (AGENT): 140149 ms
Total Talk Time (CUSTOMER): 81710 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/11/6ddaf0fc-457e-48f1-88c8-7e808c132481_20250311T19:30_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. I'm calling from LG's office because I need to know benefits for a patient.
[AGENT][NEUTRAL] Sure, I can assist you, but if I'm sorry, you said you're calling for radiology office, is that what you said?
[CUSTOMER][NEUTRAL] No, for an allergies, sorry, allergies.
[AGENT][NEUTRAL] Allergies, OK. That's OK. No problem. And may I have your name and a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Sure, my name is [PII] and the callback number here is [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] He gave me 60801.
[AGENT][NEUTRAL] Oh, yeah, that is it, that is our payer ID, uh, it's not a policy number. Um, do you have the copy of the card by any chance?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] No, I do not.
[AGENT][NEUTRAL] No. OK. All right. Uh, we can do a name search. What's the spelling of the last name?
[CUSTOMER][NEUTRAL] The last name is [PII].
[AGENT][NEUTRAL] OK, and what's the spelling of the first name?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] [PII], [PII]
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, let me see if I can find him. Bear with me just a second, OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it's without an S and then um the last name is [PII].
[CUSTOMER][POSITIVE] Correct mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm mm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] What is his date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] All right. And let me give you benefits and this is not a guarantee of payment, just a verification of coverage. Let me give you the policy number. Let me know when you're ready.
[CUSTOMER][POSITIVE] Oh thank you so much, go ahead.
[AGENT][NEUTRAL] Yeah. OK, so that's 0249.
[AGENT][NEUTRAL] 7672.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Um, actually, um, I was calling because he said that you guys will cover his co-payments.
[CUSTOMER][NEUTRAL] So I'm not sure if you guys will also cover co-payment or your deductible.
[AGENT][NEUTRAL] Mm. OK.
[AGENT][NEUTRAL] OK, I can check on that. Um, let me see his benefits really quick and this is not a guarantee of payment, just a verification of coverage. OK, so this one does have office visit benefit. Let me pull that information. It's gonna be a minute. I have to put the certificate. You're welcome.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yep.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] No
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Here it is. And let's see. So this one, if it's a specialist, we cover up to $50 per visit, maximum of 4 visits per covered person per calendar year, and we also covered the office treatments, so office procedures are subject to the outpatient maximum which is $7900 per covered person per calendar year.
[CUSTOMER][NEUTRAL] Oh, OK, so up to $50 for the specialist 4 visits a year, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] That's true, man.
[CUSTOMER][NEUTRAL] OK, perfect. And when was the effective date for this policy?
[AGENT][POSITIVE] All right, let me get that for you.
[AGENT][NEUTRAL] OK, the effective date is going to be [PII] and it is active at the moment.
[CUSTOMER][NEUTRAL] OK, perfect. Is there a reference number for this call?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name and they say if you will. Do you need the spelling of my name or any other information, Miss [PII]?
[CUSTOMER][POSITIVE] No, that will be all. Thank you so much.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good day, Miss [PII].
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Goodbye.