AccountId: 011433970860
ContactId: 76aa3f58-0540-4a2d-bc28-dfd86fa51926
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 185380 ms
Total Talk Time (AGENT): 88031 ms
Total Talk Time (CUSTOMER): 48414 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/76aa3f58-0540-4a2d-bc28-dfd86fa51926_20250528T18:48_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII], and I am calling from Botox one in a recorded line. I am calling at the request of the provider to check uh how much is the maximum reimbursable this plan will allow uh a secondary payer.
[AGENT][NEUTRAL] Um, yes, ma'am. I can assist you with benefits. Um, first, I'll need a good callback number just in case we're disconnected.
[CUSTOMER][NEUTRAL] Yes, it is [PII], option 1.
[AGENT][NEUTRAL] Thank you, [PII]. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] It is 01935517.
[AGENT][NEUTRAL] Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] It's [PII] and the 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 claims. Um, she does have a new policy number. Would you like her new policy number?
[CUSTOMER][POSITIVE] Yes, please thank you.
[AGENT][NEUTRAL] Mhm. Her new policy number is 02267455.
[CUSTOMER][POSITIVE] Got it, thank you.
[AGENT][NEUTRAL] OK, no problem. And um just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII]. The policy is still active. And is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Outpatient on the provider's office.
[AGENT][NEUTRAL] OK. The services provided in office, we cover up to 6000 per calendar year and that's for the co-insurance and the deductible after the primary insurance processes the claim, but the co-pay for the office visit is not covered. And so far this year, she has used, one moment.
[AGENT][NEUTRAL] This is for [PII]. Let's see.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, actually, she's used the full 6000 already this year.
[AGENT][NEUTRAL] Yeah, she has nothing remaining for outpatient.
[AGENT][NEUTRAL] Hello.
[AGENT][NEUTRAL] Hello, are you still there? I'm sorry. I can't hear you.
[AGENT][NEUTRAL] Hello.