AccountId: 011433970860
ContactId: 9fe12626-b43b-4aaa-bca6-e578190d7a09
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 175149 ms
Total Talk Time (AGENT): 94006 ms
Total Talk Time (CUSTOMER): 55319 ms
Interruptions: 0
Overall Sentiment: AGENT=2.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/9fe12626-b43b-4aaa-bca6-e578190d7a09_20250214T16:24_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, hi, this is Doctor [PII]. I'm trying to check uh benefits on this other patient of ours.
[AGENT][POSITIVE] OK, well, I'll be more than happy to assist you with the benefits. Did you say your name is Doctor [PII]?
[CUSTOMER][NEUTRAL] [PII], yes.
[AGENT][NEUTRAL] OK. And may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Policy number is 02573035.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] uh sorry [PII]. I also have his wife here.
[AGENT][NEUTRAL] OK, and which one is the patient?
[CUSTOMER][NEUTRAL] Uh, his the patient well they're both, but today she's here, [PII], her date of birth.
[AGENT][NEUTRAL] All right, and just her first name.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Alright thank you so much for verifying all the information provided is a verification of benefits, not a guarantee of payments, and you said eligibility?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And I am showing the policy is active. It's been effective since [PII].
[CUSTOMER][NEUTRAL] OK, does she have chiropractic benefits? This is a major med? is this a hospital? What does this cover?
[AGENT][NEUTRAL] So this is um their secondary policy. So we're second to, let me see, hold on one moment.
[AGENT][NEUTRAL] We're second to the United Healthcare, so we pay towards the co-pay, deductible and co-insurance of coverage charges after primary. Um, let me check on chiropractic for you.
[AGENT][NEUTRAL] And again, just for the call, all the information provided is a verification of benefits, not a guarantee of payment. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so chiropractic benefits are not covered on their secondary policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And could you tell me what is covered because I know the patient's gonna ask me, is it just regular uh doctor's offices as major med or what?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So they have inpatient benefits and outpatient benefits. Outpatient would be outpatient facilities, um, outpatient surgeries, emergency room, urgent care, um, there's no in-office setting coverage. We have an office treatment rider which would cover the treatment, but they don't have that on this policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alrighty very good thank you very much.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Nope, that's it.
[AGENT][POSITIVE] Alright, well, thanks for calling APL and happy [PII].
[CUSTOMER][POSITIVE] Same to you. Have a good day bye bye.
[AGENT][POSITIVE] Thank you. Bye bye.