AccountId: 011433970860
ContactId: 708d9266-8d08-473d-bb8c-e2926723de47
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 244539 ms
Total Talk Time (AGENT): 94254 ms
Total Talk Time (CUSTOMER): 59292 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/23/708d9266-8d08-473d-bb8c-e2926723de47_20250423T19:15_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, I'm calling uh for benefits for a patient that's coming in for a specialist office visit and ultrasound.
[AGENT][POSITIVE] OK, sure. I can assist you with benefits um for office. And may I have your name and callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah, my name is [PII]. Call back is [PII].
[AGENT][NEUTRAL] OK, may I have the name of the facility you're calling from for my notation?
[CUSTOMER][NEUTRAL] Is uh Florida Woman Care.
[AGENT][NEUTRAL] Thank you and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] It's 02492183 ML 8.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] Con Conico [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you. And before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer.
[AGENT][NEUTRAL] And let me have all the benefit information on this 11 moment.
[AGENT][NEUTRAL] This is one of our secondary supplemental plans for the major medical.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, looks like with this one we cover procedures done in the office, but we do not cover the office visit benefit, the consultation.
[AGENT][NEUTRAL] The office treatment is subject to the outpatient maximum, which is 3000 per cover person per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Has anything been used on it?
[AGENT][NEUTRAL] I can check. Let's see.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] No one.
[AGENT][NEUTRAL] OK. For [PII] as of today, he has not, she has, she has not used her benefits. So she still have the full amount available. I'm sorry.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK perfect so um and it's 3000 right? for outpatient?
[AGENT][NEUTRAL] Yes, 3000 per person per calendar year.
[CUSTOMER][NEUTRAL] OK, um, let me see something. So just to clarify, the ultrasound is covered, but the um office visit is not.
[AGENT][POSITIVE] Correct, Miss [PII]. Mhm, yes.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Alright alright sounds good uh what was your name again? I'm sorry.
[AGENT][NEUTRAL] My name is [PII]. Is there anything else I may help you with today?
[CUSTOMER][NEUTRAL] No, that's it. Do you have a reference number for the call?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you like.
[CUSTOMER][POSITIVE] OK, that's fine. All right, thank you for your help.
[AGENT][POSITIVE] OK. You're welcome and thank you for calling ATO. Have a good afternoon.
[CUSTOMER][NEUTRAL] All right bye bye.
[AGENT][NEUTRAL] No