AccountId: 011433970860
ContactId: ad648863-a836-4c5f-9c71-f27eeecaa9e3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 259140 ms
Total Talk Time (AGENT): 118850 ms
Total Talk Time (CUSTOMER): 55075 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/ad648863-a836-4c5f-9c71-f27eeecaa9e3_20250509T16:56_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Take care.
[CUSTOMER][NEUTRAL] Hi, good afternoon, my name's [PII]. I'm calling from Urology Specialty care. Uh, any sort of benefits for a patient, please.
[AGENT][NEUTRAL] OK, you're needing benefit information, [PII], phone number, is that correct?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, ma'am, I can help you with that, but you do not need eligibility. Is that correct? Just benefits?
[CUSTOMER][POSITIVE] Just benefits, yeah.
[AGENT][NEUTRAL] OK, um, and what is a good callback number for you please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. Oh, I'm so sorry. What was your extension?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and the member's policy number?
[CUSTOMER][NEUTRAL] The policy number is.
[CUSTOMER][NEUTRAL] 1960138.
[AGENT][NEUTRAL] OK, thank you. One moment please.
[AGENT][NEUTRAL] And any information, [PII] that I do provide will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] [PII] uh [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] And do you need inpatient, oh bless you. Do you need inpatient, outpatient or office benefits?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Uh, office specialist office.
[AGENT][NEUTRAL] OK, so let me look at one piece of information just one.
[CUSTOMER][POSITIVE] No worries
[AGENT][NEUTRAL] OK, so on this supplemental policy, [PII], office visits are not covered.
[AGENT][NEUTRAL] However, if he were to receive some type of treatment in the office that could be reviewed under his outpatient benefit maximum.
[AGENT][NEUTRAL] Which is $1500 per calendar year for covered outpatient services and no deductible, but again, the office visit is not covered.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now if you all do.
[CUSTOMER][NEUTRAL] OK, has any of the mhm.
[AGENT][NEUTRAL] I was just gonna go ahead, you want to know if there's anything been used on his benefits this year?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And as of now, no, ma'am, there has not.
[CUSTOMER][POSITIVE] OK perfect.
[AGENT][NEUTRAL] Now if you all end up filing a claim with us for this member, we will also have to have a copy of his primary insurance company's explanation of benefits as well and then once we have processed our claim here we do have a portal that you should be able to check our claim status in.
[AGENT][POSITIVE] And that website for our portal is secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] OK. And is there anything else?
[CUSTOMER][NEUTRAL] And can I just have your name again?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And a reference number?
[AGENT][NEUTRAL] My name and today's date.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Perfect thank you so much, [PII] have a great day.
[AGENT][POSITIVE] I hope you have a great day too, and thank you again for calling APL.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye-bye.