AccountId: 011433970860
ContactId: 718fe4a8-bf4e-49e1-919c-2a263caef765
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 327579 ms
Total Talk Time (AGENT): 82028 ms
Total Talk Time (CUSTOMER): 44509 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/22/718fe4a8-bf4e-49e1-919c-2a263caef765_20250422T17:10_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. My name is [PII]. I'm just calling to verify the eligibility and benefits of a patient.
[AGENT][NEUTRAL] OK, [PII], I can help you with eligibility and benefits. Do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, um, 02481567 ML 8.
[AGENT][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] And then what's a good call back number in case our call gets dropped?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] OK. And then patient's first and last name and date of birth, please?
[CUSTOMER][NEUTRAL] Uh, [PII], [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so it looks like the policy is active. The effective date is [PII].
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] And then is this for an office visit?
[CUSTOMER][NEUTRAL] Um, it's for an outpatient MRI.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, can I put you on a brief hold while I look into their policy?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] OK, thank you for holding.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so this is not a guarantee of payment, it's just a verification of coverage. So it looks like an MRI falls under the outpatient benefit max, and that is $3000 per covered person per calendar year for covered outpatient service.
[CUSTOMER][NEUTRAL] Has she met any of the 3000 yet?
[AGENT][NEUTRAL] Uh, let's see if she's used anything.
[AGENT][NEUTRAL] OK, so it looks like she's only used $30 for the outpatient benefit amount.
[CUSTOMER][NEUTRAL] OK. Perfect. OK. Can I have the initial to your last name and a reference number?
[AGENT][NEUTRAL] Yeah, of course. So my initials [PII] and then the reference number is going to be my name, which is [PII], last initial [PII] and then today's date.
[CUSTOMER][POSITIVE] OK. Perfect. Thank you so much.
[AGENT][NEUTRAL] Of course. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] No, that was all.
[AGENT][POSITIVE] OK. Well, thanks for calling APL. Have a good day, [PII].
[CUSTOMER][POSITIVE] You too. Thank you. Bye-bye.
[AGENT][NEUTRAL] OK, bye.