AccountId: 011433970860
ContactId: 969ae8c7-4c27-4eed-8974-b38ed3a1a85b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 154500 ms
Total Talk Time (AGENT): 79199 ms
Total Talk Time (CUSTOMER): 43016 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/969ae8c7-4c27-4eed-8974-b38ed3a1a85b_20250123T20:21_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, my name is [PII]. I am calling from MRI scan center to verify benefits for a member.
[AGENT][POSITIVE] Well, thank you, [PII]. What is a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] 022 03953ML8
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth please, ma'am.
[CUSTOMER][NEUTRAL] Is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] All right, thank you. And you're needing eligibility and benefits, as I understand for [PII], correct?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] All right, I can help you with that.
[AGENT][NEUTRAL] [PII], I am showing that [PII]'s policy is active.
[AGENT][NEUTRAL] Effective date, sorry, is [PII].
[AGENT][NEUTRAL] This is a secondary policy to her major medical coverage.
[AGENT][NEUTRAL] And are there specific benefits you're needing?
[CUSTOMER][NEUTRAL] Um, outpatient office for a PET scan.
[AGENT][NEUTRAL] OK. Now, on her policy, she does have the office treatment writer which does cover procedures or treatments performed in a doctor's office.
[AGENT][NEUTRAL] That is under her outpatient coverage, and that benefit amount is $6000 per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And that is a verification of coverage, not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And just
[CUSTOMER][NEUTRAL] And has she met any of that amount this year?
[AGENT][POSITIVE] As of right now, she has that full benefit remaining at this moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that is a verification of coverage, not a guarantee of payment.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Is there anything else I can help you with?
[CUSTOMER][POSITIVE] Nope, that was it. I greatly appreciate that thank you very much.
[AGENT][POSITIVE] Well, it has been such a pleasure to assist you and thank you for calling APL. I hope you have a wonderful day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you, [PII]. Bye-bye.
[CUSTOMER][NEUTRAL] Sure.