AccountId: 011433970860
ContactId: 8ea08cfb-0d08-4b58-bb14-0d2953fe6c42
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 185229 ms
Total Talk Time (AGENT): 95673 ms
Total Talk Time (CUSTOMER): 76279 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/8ea08cfb-0d08-4b58-bb14-0d2953fe6c42_20250529T14:10_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling APL. This is speaking. May I help you?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yes, I'm calling to get benefits for a patient. She's coming to see us for her pregnancy.
[AGENT][NEUTRAL] OK, I can verify benefits for you and your name is?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, Ms. [PII], what is the policy number, please?
[CUSTOMER][NEUTRAL] It is 01829134 M like Mary L like Larry and the number 7.
[AGENT][POSITIVE] OK, thank you so much, give me one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and do you have a callback excuse me, callback number in case the call drops? Sorry.
[CUSTOMER][NEUTRAL] 3
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, I just decided to have hiccups that moment. Give me one moment.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] And the patient's name, date of birth?
[CUSTOMER][NEUTRAL] I, oh, [PII], last name [PII] Date of birth [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I'm showing her effective date is [PII]. She is active on the policy.
[AGENT][NEUTRAL] And you said you're needing pregnancy or maternity benefits?
[CUSTOMER][NEUTRAL] Yes, she has a deductible and um a co-insurance with her primary insurance. I was just wondering if that's something you guys pick up.
[AGENT][NEUTRAL] Uh, yes, ma'am. Uh, with this policy is secondary, it helps with primary insurance deductible, co-pay, and or co-insurance.
[AGENT][NEUTRAL] Um, she doesn't have any benefits for office visits. However, she does have a writer that covers treatment performed in office, and that's covered as outpatient.
[AGENT][NEUTRAL] And not a guarantee of payment, just a verification of coverage. She has a benefit max of up to $500 per calendar day for outpatient.
[CUSTOMER][NEUTRAL] Oh, OK, and I'm assuming that can be used towards her delivery of baby.
[AGENT][NEUTRAL] Uh, yes ma'am. She has an inpatient benefit, uh, that pays up to $500 per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so is that 2 separate $500?
[AGENT][NEUTRAL] Yes ma'am, it's two separate benefits, one for outpatient, one for in hospital.
[CUSTOMER][NEUTRAL] OK, and let me ask you this for the outpatient, we do ultrasounds here at the office during the pregnancy. Would that be a covered benefit because it is in the office?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, yes, ma'am. If it's performed in office, it is covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just not like the office visit itself.
[AGENT][POSITIVE] Correct. Yes, ma'am.
[CUSTOMER][POSITIVE] OK, got you. OK, perfect, and I'm sorry I didn't catch your name at the beginning of the call.
[AGENT][NEUTRAL] It's [PII], last initial [PII]
[CUSTOMER][NEUTRAL] OK perfect and can I please have a reference number to our phone call?
[AGENT][NEUTRAL] Uh, if you like, you may use my name in today's date.
[CUSTOMER][POSITIVE] OK, perfect. Thank you so much.
[AGENT][POSITIVE] Uh yes, ma'am. Thank you for calling APL. Have a great day, Ms. [PII].
[CUSTOMER][POSITIVE] You too take care bye.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Bye.