AccountId: 011433970860
ContactId: 9cf63b0c-96d2-4475-b1cd-0a607e0d386f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 154490 ms
Total Talk Time (AGENT): 60518 ms
Total Talk Time (CUSTOMER): 74320 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/9cf63b0c-96d2-4475-b1cd-0a607e0d386f_20250513T18:59_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APR. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, [PII], I'm calling from a provider's office and I need benefits for a member.
[AGENT][POSITIVE] Yes, ma'am. I can assist you with benefits. Um, first, I'll need your name and a good callback number.
[CUSTOMER][NEUTRAL] It's [PII], it's [PII] and it's [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now, could I get the policy number, please?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] It is um 01611610, excuse me, ML8.
[AGENT][NEUTRAL] Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Thank you and just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII]. The policy is still active. And is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Um, actually, this is gonna be for an MRI that's gonna be done in the specialist office. So like we're not like a facility, we build, um, an office settings, so, uh, as far as I remember, I needed to know if this plan has any office treatment writer for the MRI.
[AGENT][NEUTRAL] Um, yes, ma'am. It does have an office treatment rider. We cover up to 1500 per calendar year and that's for the co-insurance and the deductible, but any co-pays for office visits is not covered.
[CUSTOMER][NEUTRAL] OK. So it's 1500. Let me ask you, Kay, have, uh, is that still available or have they used any of that amount?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] It's still available.
[CUSTOMER][NEUTRAL] 0. OK. Uh, let's see. That'll be all, [PII]. Can I get like a reference number?
[AGENT][NEUTRAL] Um, yes, for the reference number, you can use my name and today's date. Um, is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Uh, no, that'll be all. What's the initial of your last name?
[AGENT][NEUTRAL] Um, it's [PII].
[CUSTOMER][POSITIVE] Great. Thank you very much, [PII]. You have a great day.
[AGENT][NEUTRAL] You do the same bill because thank you for calling ATL. bye.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.