AccountId: 011433970860
ContactId: 81a71dfa-46df-44b6-9c4f-56f208d22af8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 203240 ms
Total Talk Time (AGENT): 114358 ms
Total Talk Time (CUSTOMER): 31877 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/81a71dfa-46df-44b6-9c4f-56f208d22af8_20250304T19:31_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] and I'm calling to verify benefits for our patient.
[AGENT][POSITIVE] OK, well, I'll be more than happy to assist you with the benefits and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII], no extension.
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] 02473906
[AGENT][POSITIVE] Thank you. Hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So I am showing the policy is active. It's been effective since [PII]. And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] Um, as far as sleep study done at home.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And do you mind if I place you on just a brief hold while I look through the benefits?
[CUSTOMER][NEUTRAL] I don't go ahead.
[AGENT][NEUTRAL] All right, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, now this one needs what class office treatment writer.
[AGENT][NEGATIVE] That really hurt my feelings.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, I don't have the office.
[AGENT][NEGATIVE] We don't need uh uh it's not covered.
[AGENT][NEUTRAL] Hello [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you so much for holding. I apologize for that wait. So, the um, sleep studies wouldn't be covered by this policy because they don't have the office treatment rider, um, which will cover the treatment in the office um up to like a calendar or max, calendar year max or day max. Um, they do have the
[AGENT][NEUTRAL] Um, hold on, let me go back up to it.
[AGENT][NEUTRAL] Sorry, when I went back off a hold, it scrolled and um left the page I was on. Um, so they do have the, um,
[AGENT][NEUTRAL] Like if there's treatment in the hospital, outpatient facility, freestanding emergency room, or the physician office, it's up to $25 per visit with a max of 4 visits per calendar year, um, but they don't have the office treatment writer.
[AGENT][NEUTRAL] On its own to cover the sleep studies.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Alright, and is there a reference number for the call?
[AGENT][NEUTRAL] Um, so there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] All right, thank you so much for your help and uh you have a great day.
[AGENT][POSITIVE] Thank you, you also, and thanks for calling APL.
[CUSTOMER][POSITIVE] You're welcome, good bye.
[AGENT][NEUTRAL] Bye bye.