AccountId: 011433970860
ContactId: 79bd9655-2f78-460f-b7d6-0e39da54568f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 148020 ms
Total Talk Time (AGENT): 89729 ms
Total Talk Time (CUSTOMER): 54886 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/07/79bd9655-2f78-460f-b7d6-0e39da54568f_20250307T19:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, good afternoon. I'm calling from University of Virginia Medical Center. I need to verify coverage, um, really benefits for our patient.
[AGENT][POSITIVE] Here, I can check benefits for you. Uh, what was your name?
[CUSTOMER][POSITIVE] It's [PII].
[AGENT][NEUTRAL] OK, [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and then do you have the policy number?
[CUSTOMER][NEUTRAL] I do. It's 023-31430.
[AGENT][NEUTRAL] OK, and then what was the name and date of birth for the insured, please?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, perfect. Thank you for verifying that [PII]. Uh, so this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays, and we really need to look at, uh, inpatient or outpatient benefits.
[CUSTOMER][NEUTRAL] Um, so it's outpatient. It's an office visit to see a specialist. Um, and does it pick up the medi, oh no, never mind, they don't have Medicare. Forget, never mind, mm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That's OK.
[AGENT][NEGATIVE] These policies can be a bit confusing.
[CUSTOMER][NEUTRAL] I'm so, I'm so used to asking that. Um, um, I, it, no referrals required, right?
[AGENT][NEUTRAL] That's OK. Um, oh, go ahead.
[AGENT][NEUTRAL] Right, so this policy is very dependent on a major medical, so in short, as long as they are willing to pay this policy can if they don't this policy can't, um, so under this particular policy office visits themselves are not covered, uh, however treatment received in office could be.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So if it were simply a consultation or something like that then it would not be covered.
[AGENT][NEUTRAL] And of course I will also let you know verification of coverage is not a guarantee of payment for claims. uh, their total outpatient benefit is $1500 max per calendar year.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, alright, do you have a reference number for this call?
[AGENT][NEUTRAL] It would just be my first name, last initial, and today's date, um so my name is spelled [PII] Was there anything else I can help you with, [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Nope, that's it. I appreciate your help thank you.
[AGENT][POSITIVE] Alright, of course, thanks for calling APL thank you bye bye.
[CUSTOMER][POSITIVE] Thanks bye bye