AccountId: 011433970860
ContactId: 9cc10cd3-352b-49bd-ad38-b445df7c2b79
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 138830 ms
Total Talk Time (AGENT): 72980 ms
Total Talk Time (CUSTOMER): 52580 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/9cc10cd3-352b-49bd-ad38-b445df7c2b79_20250326T13:45_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes, hi [PII]. How are you? Um, I am calling to verify benefits on, on one of your members.
[AGENT][POSITIVE] OK, sure, I can assist you with benefits and may I have your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK, thank you, Miss [PII]. And may I have a callback number just in case we get disconnected and the name of the facility?
[CUSTOMER][NEUTRAL] [PII] and the name of the facility is Vital MD Group Holding LLC.
[AGENT][NEUTRAL] OK, and you said you needed benefits. OK, and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yes, it is 025.
[CUSTOMER][NEUTRAL] 17,200 M as in mother, L as in Lima 8.
[CUSTOMER][NEUTRAL] But I understand, so is that this is a gap insurance for hospital inpatient and outpatient services, but this is not gonna cover anything in a doctor's office, am I right?
[AGENT][NEUTRAL] I, I can check. OK. May I have the name and date of birth of the patient, Miss [PII]? You're welcome.
[CUSTOMER][POSITIVE] Thank you. I appreciate it.
[CUSTOMER][NEUTRAL] Yes, it is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, and all of our policies are different, that's fine, OK, so bear with me just a second, let me pull this CS benefit.
[AGENT][NEUTRAL] This is not a guarantee of payment, just a verification of coverage and that's just a disclaimer, and this is a secondary policy to the major medical. This one covers office procedures, office treatment. It does not cover the office visit, but it does cover office procedures. And the office procedures are subject to the outpatient maximum, which the outpatient maximum is 750 per day.
[CUSTOMER][NEUTRAL] maximum.
[CUSTOMER][NEUTRAL] But it wouldn't cover the copay for the visit. Am I right?
[AGENT][NEUTRAL] Not the visit. We do not cover the visit. We only cover procedures done in the office.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, sure, so can I have a reference number so for this call please?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's state if you will.
[CUSTOMER][POSITIVE] OK, thank you so much and you have a nice day, OK?
[AGENT][POSITIVE] You're welcome. You as well. Thank you for calling ATM. mhm Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.