AccountId: 011433970860
ContactId: 8271460c-96b6-4335-a1b5-ed4382367e5f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 173660 ms
Total Talk Time (AGENT): 71698 ms
Total Talk Time (CUSTOMER): 84459 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=2.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/8271460c-96b6-4335-a1b5-ed4382367e5f_20250408T17:33_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Good afternoon. I'm calling from University of Virginia Medical Center. I need to verify benefits for our patient, please.
[AGENT][NEUTRAL] Sure, I could assist you with that. Can I have your name and a callback number?
[CUSTOMER][NEUTRAL] My name is [PII], last initial [PII]. Callback number is [PII].
[AGENT][POSITIVE] Thank you, [PII].
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] What is the policy number of the member that you're calling to verify benefits for?
[CUSTOMER][NEUTRAL] It is 1563838 for [PII].
[AGENT][NEUTRAL] And what is [PII]'s date of birth?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Do you have, do [PII] go by another name?
[CUSTOMER][NEUTRAL] Um, so he's got, let's see, [PII], let's see we go [PII].
[AGENT][NEUTRAL] OK, that's the name that we have in the system.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] And give me his date of birth one more time because the name when I didn't see the name match it threw me off.
[CUSTOMER][NEUTRAL] It's OK. [PII].
[AGENT][NEUTRAL] Thank you, [PII]. You're calling to verify benefits and eligibility, so let me give you the correct policy number. Let me know when you're ready for it.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][POSITIVE] OK, I'm ready.
[AGENT][NEUTRAL] It is 228-7978.
[CUSTOMER][POSITIVE] Perfect, I'll change that in the system.
[AGENT][NEUTRAL] And this policy has been active since [PII].
[CUSTOMER][NEUTRAL] Is this a supplement or is it just secondary because it because he's got [PII] as primary. OK, gap insurance, um, is there any exclusions like it's not gonna, it only covers certain things.
[AGENT][NEUTRAL] It's a gap insurance.
[AGENT][NEUTRAL] Yeah, what, what place of service are you inquiring about?
[CUSTOMER][NEUTRAL] It's uh it's a orthopedic orthopedic specialist office visit, yes.
[AGENT][NEUTRAL] So the members policy has
[CUSTOMER][NEUTRAL] So does it cover office business?
[AGENT][NEUTRAL] It doesn't cover office visits, however, it does cover the treatment received in the office, which falls under his outpatient benefits of $3000 per calendar year.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this is not a guarantee of benefits, just a disclaimer of the policy's coverage. So the treatment received in the office will be covered but not the visit itself.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I got you. OK, um, I made note of that and that's really all I needed if you have a reference number I'll take it.
[AGENT][NEUTRAL] We don't provide those, however, you can use my name in today's date as a reference.
[CUSTOMER][POSITIVE] OK, I appreciate your help.
[AGENT][NEUTRAL] And my name is [PII]
[CUSTOMER][POSITIVE] OK, thanks so much for your help you have a great day.
[AGENT][POSITIVE] You're welcome. Thanks for calling APA. You have a great one as well. Goodbye.
[CUSTOMER][POSITIVE] Thank you bye bye.