AccountId: 011433970860
ContactId: 79e9c6da-bbd1-4dd2-b812-bb8a5d978504
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 127819 ms
Total Talk Time (AGENT): 70142 ms
Total Talk Time (CUSTOMER): 36948 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/26/79e9c6da-bbd1-4dd2-b812-bb8a5d978504_20250226T16:35_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. I'm calling to see if I could verify benefits on a patient.
[AGENT][POSITIVE] Sure, I could check benefits for you. Uh, what was your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, OK, so can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] It is 02473091ML8.
[AGENT][NEUTRAL] Thank you. And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] It is [PII] [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that, so. 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 the uh outpatient benefits.
[CUSTOMER][NEUTRAL] Yes, for MRI coverage being done in the office.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims, so their outpatient benefit is on a per calendar day basis. It pays up to $300 max per calendar day.
[CUSTOMER][NEUTRAL] OK it's up to 300.
[CUSTOMER][NEUTRAL] Max per day you said?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, so it covers the co-pay if they have a copay with the primary?
[AGENT][NEUTRAL] Co-pay, deductible and co-insurance. Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, and no pre-cert.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, and do you give reference numbers?
[AGENT][NEUTRAL] Uh, it would just be my first name, last initial, and today's date. Uh, so my name is spelled [PII] Uh, was there anything else I could help you with?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] No, that's it. Thank you very much.
[AGENT][POSITIVE] OK, yep, thanks for calling APL. I hope you have a good rest of your day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.