AccountId: 011433970860
ContactId: a0a2520a-8f9e-4b88-bc2c-2a77745f33ae
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 229779 ms
Total Talk Time (AGENT): 81263 ms
Total Talk Time (CUSTOMER): 66287 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/a0a2520a-8f9e-4b88-bc2c-2a77745f33ae_20250218T20:34_UTC.wav
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[AGENT][NEUTRAL] Afternoon, thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Hi, yes, I'm calling to verify benefits for a patient for specialist offices.
[AGENT][NEUTRAL] OK, I can verify benefits for you and your name is?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and Ms. [PII], what is that policy number?
[CUSTOMER][NEUTRAL] 02518811
[AGENT][NEUTRAL] OK. Thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. Thank you, ma'am. And verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] Her name is [PII] and her date of birth is [PII].
[AGENT][NEUTRAL] OK, I show her effective date is [PII]. She is active on the policy. And you say you're needing office visit benefits?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Ex
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] One.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Uh, give me one moment.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] a moment.
[CUSTOMER][NEGATIVE] Nothing yellow. Nothing yellow.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Just a moment
[AGENT][NEUTRAL] Uh, let's see.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. I just wanna double check and see if it's covered.
[AGENT][NEUTRAL] Uh, not a guarantee. Well, under the policy, it does not cover office visits. Um, they do have a writer covers procedures in office, but visits themselves are not covered.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] But if uh the patient does any.
[CUSTOMER][NEUTRAL] In office procedure.
[CUSTOMER][NEUTRAL] Or testing that is covered?
[AGENT][NEUTRAL] Uh, yes, services and procedures in office for sickness or injury is covered, it's not the visit.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and what is the benefit for that, for the services and procedures?
[AGENT][NEUTRAL] Uh, not a guarantee of payment, just a verification of coverage. Uh, the insured has a benefit max that pays up to $300 per calendar day of what primary applies towards the deductible co-pay or coinsurance for those procedures.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. OK, and your name is?
[AGENT][NEUTRAL] Uh, my name is [PII], last initial [PII]
[CUSTOMER][NEUTRAL] And the reference number for that call?
[AGENT][NEUTRAL] Numbers, however, you may use my name in today's state if you like.
[CUSTOMER][POSITIVE] Oh OK, OK, thank you.
[AGENT][POSITIVE] Uh yes, ma'am. Thank you for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] Bye, you too, bye.
[AGENT][NEUTRAL] Bye.