AccountId: 011433970860
ContactId: 73131204-ba1c-4d27-9edf-4f06b81b880f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 183970 ms
Total Talk Time (AGENT): 62440 ms
Total Talk Time (CUSTOMER): 95055 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/73131204-ba1c-4d27-9edf-4f06b81b880f_20250121T21:30_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII]. You OK?
[AGENT][NEUTRAL] Yes, ma'am. Yes.
[CUSTOMER][NEUTRAL] That's OK. This is [PII] Resources. I have a provider that's needing to verify some benefits on a med link policy.
[AGENT][NEUTRAL] The policy number.
[CUSTOMER][NEUTRAL] It is 258-516-7.
[CUSTOMER][NEUTRAL] [PII] for that wrong, um, the lady on the line her name is [PII].
[CUSTOMER][NEUTRAL] And her callback number is [PII].
[CUSTOMER][NEUTRAL] And I didn't verify the date of birth and all the other stuff I forgot, so sorry.
[AGENT][POSITIVE] No worries, I'll do it. You can send over.
[CUSTOMER][POSITIVE] OK. OK, thank you. Have a great day.
[AGENT][POSITIVE] You're welcome. Have a good one.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Are you there?
[CUSTOMER][POSITIVE] Yes, [PII], [PII], OK, I've got [PII] on the phone. She's gonna help you, OK, thank you so much. I wish you have a great day. Thanks for calling APL. Bye bye.
[AGENT][NEUTRAL] I'm here.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] Hello, [PII]. My name is [PII] and I'll be assisting you. Could you provide me with the member's name and date of birth?
[CUSTOMER][NEUTRAL] Me, I'm sorry, the name is uh [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] And you're calling to verify benefits and eligibility for what place of service?
[CUSTOMER][NEUTRAL] It's a neurologist's office visit.
[AGENT][NEUTRAL] So the treatment received in the office is covered under the policy, but the office visit itself is not covered, and the treatment received falls under falls under the outpatient benefit.
[CUSTOMER][NEUTRAL] And the, the patient, the patient has uh Blue Cross and Blue Shield, but uh she also have a copay.
[AGENT][NEUTRAL] This is the gap insurance.
[CUSTOMER][POSITIVE] Yes, exactly.
[AGENT][NEUTRAL] We don't cover office visits, just the treatment received in the office.
[CUSTOMER][NEUTRAL] OK, no office visit, only the treatment. OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Good to know. So she have to pay the, she has to pay the, the copay.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] Well, I can't tell you that. I can only verify her benefits here with APL with her gap insurance and she only has coverage for the treatment received in the office because I'm not sure how they bill it. I'm not sure if they're gonna bill it with as an office visit or they're gonna bill it as a treatment received in the office.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, but uh the billing department, OK, uh, I'm gonna put her insurance uh on file so the billing department can.
[CUSTOMER][NEUTRAL] Uh, bill you and you see if you pay or not, right?
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] OK perfect thank you so much appreciate it.
[AGENT][NEUTRAL] You're welcome. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEGATIVE] No thank you.
[AGENT][POSITIVE] Thank you for calling APL. Have a good day. Bye bye.
[CUSTOMER][NEUTRAL] Same to you bye.