AccountId: 011433970860
ContactId: 72efe737-2a4e-42c7-8547-97d0683f52bc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 164559 ms
Total Talk Time (AGENT): 78453 ms
Total Talk Time (CUSTOMER): 48262 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/07/72efe737-2a4e-42c7-8547-97d0683f52bc_20250307T16:21_UTC.wav
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[AGENT][POSITIVE] And thank you for calling APL. This is [PII]. How can I help you?
[AGENT][POSITIVE] Thank you for calling
[CUSTOMER][NEUTRAL] Hi, I'm calling from [PII].
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes, ma'am. I'm here.
[CUSTOMER][NEUTRAL] Hi, I'm calling from [PII]. I needed to verify a patient please.
[AGENT][POSITIVE] Um, yes, ma'am. I can assist you with benefits. First, could I get your name and a good callback number?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh, sure. My name is [PII].
[CUSTOMER][NEUTRAL] Call the number [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now, could I get the policy number, please?
[CUSTOMER][NEUTRAL] It is
[CUSTOMER][NEUTRAL] It's 021-75431 M as in mom, L as in Lima 8.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK. Thank you and just let me advise you that verification of coverage does not guarantee payment of claim. Um, the effective date on this policy was [PII] and the policy is still active. Um, is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] At the specialist office they say.
[AGENT][NEUTRAL] OK, actually, under this policy, services provided in the doctor's office is not covered.
[CUSTOMER][NEUTRAL] OK, so if the patient has like a nasal endoscopy or anything like that, it won't be covered either?
[AGENT][NEUTRAL] That's if it, if it takes place in the doctor's office, um, if it takes place in an outpatient facility for outpatient facilities, we cover up to
[AGENT][NEUTRAL] $500 per day and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim.
[CUSTOMER][NEUTRAL] OK, can I have a reference number for this patient?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] Yeah, can you spell your name for me?
[AGENT][NEUTRAL] Yes, it's [PII]. It's spelled [PII] and my last initial is [PII], and today's date is the reference number.
[CUSTOMER][POSITIVE] 3725. Alright, Ay, thank you so much for your help. Have a nice weekend.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL bye.
[CUSTOMER][POSITIVE] Alright thank you.