AccountId: 011433970860
ContactId: 72362b21-abd1-4bca-906c-cada4c771f8b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 266179 ms
Total Talk Time (AGENT): 152140 ms
Total Talk Time (CUSTOMER): 67601 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/14/72362b21-abd1-4bca-906c-cada4c771f8b_20250314T15:49_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Hi is [PII]. My name is [PII]. I'm calling from Cardiovascular Medicine Associates, and I'm trying to verify benefits for a patient, please.
[AGENT][POSITIVE] OK, Ms. [PII], I'd love to help you verify some benefits today. Do you mind if I also go ahead and take a good call back number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure. [PII].
[AGENT][POSITIVE] Wonderful. And what's that policy number, ma'am?
[CUSTOMER][NEUTRAL] 02185085 M as in Mary, L as in Larry, the number 8.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you, I appreciate that and give me just a moment or two to get that all pulled up for you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] My pleasure. Are you having a wonderful day so far?
[CUSTOMER][POSITIVE] I will be happier when it's time to clock out.
[AGENT][NEUTRAL] It's, I mean, it's Friday we're almost there.
[CUSTOMER][POSITIVE] Ready, I know, I know, I'm ready.
[AGENT][NEUTRAL] All right, and I do have that Ms. [PII], and I'm sorry, what?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] No, no, I was just asking how your day was.
[AGENT][POSITIVE] Oh, I'm wonderful. The sun's shining. It's Friday, it's Pi Day. I'm all in.
[AGENT][NEUTRAL] Um, what is, uh, the insured's first and last name and date of birth, pretty please?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] [PII]. Perfect. I do see that here and I am showing however that she has an updated policy number with us. Is that something I can give you today?
[CUSTOMER][POSITIVE] Yes, absolutely, thank you.
[AGENT][POSITIVE] Yes, it's my pleasure. I'm showing her new policy number is 02337102.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And she is current and active with this policy. You said we were looking for benefits are they inpatient or outpatient today?
[CUSTOMER][NEUTRAL] Outpatient, um, just to see if she covers her diagnostic, uh, testing in the specialist office.
[AGENT][NEUTRAL] OK, let's take a peek at that. I do wanna let you know any benefit information I give you over the phone today is a verification of coverage and never a guarantee of payment.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Alright, so I'm actually going to pull up the part of her policy that gives me where she's covered like location wise, but I am showing her outpatient benefits are up to $1000 per calendar year.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] We're wanting to know about diagnostics in an office setting, is that correct?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm so sorry, Ms. [PII], you cut out on me. I'm not sure if I heard you.
[CUSTOMER][NEUTRAL] No, no, I'm just writing the notes. He has $1000 album per calendar year.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] For calendar year, yes, and so I'm showing I'm just gonna, sorry this is like a 50 page document. Hang tight with me just a second.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] Here it is, so I'm showing that the only.
[AGENT][NEUTRAL] Coverage she has for diagnostic testing is for in a hospital outpatient facility or an MRI facility. I'm not showing it as um effective in an office setting.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, no problem. I'll let her know. And then um is uh allowable, has she met anything towards her allowable?
[AGENT][NEUTRAL] Towards her, um.
[AGENT][NEUTRAL] Let me look at her calendar year benefits for you.
[AGENT][NEUTRAL] 25 she has not used any of her calendar year benefits with us so far.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] This policy only covers diagnostic testing.
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] OK. Can I please have a car reference number?
[AGENT][NEUTRAL] Oh yes, you betcha. Um, it's gonna be my name [PII], first initial last name, [PII], and then today's date.
[CUSTOMER][POSITIVE] Thank you so much, Ms. [PII]. I hope you have a great rest of your day and have a great weekend.
[AGENT][POSITIVE] Hey you too thank you so much you have a wonderful day, Ms. [PII]. Thanks for calling APL.
[CUSTOMER][NEUTRAL] Bye-bye.