AccountId: 011433970860
ContactId: aff23cca-331f-430b-8783-2ca26a82edb9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 364100 ms
Total Talk Time (AGENT): 112409 ms
Total Talk Time (CUSTOMER): 130815 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/aff23cca-331f-430b-8783-2ca26a82edb9_20250513T17:18_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello [PII]. This is [PII]. I'm calling to check um general benefits for one of our patients.
[AGENT][POSITIVE] OK, I can assist with that and my apologies. May I have your name again?
[CUSTOMER][NEUTRAL] Yes, my name is [PII].
[AGENT][POSITIVE] OK, thank you so much.
[CUSTOMER][NEUTRAL] And you said your name is [PII], right?
[AGENT][NEUTRAL] Yes, that is correct. And Tyus, what is your callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] What is the policy number, please? Thank you.
[CUSTOMER][NEUTRAL] Uh yes, give me a moment.
[CUSTOMER][NEUTRAL] Uh, I have 01603030 Mike L Lima number 8.
[AGENT][NEUTRAL] OK, I do apologize, your voice broke up. If you could just repeat that for me one more time.
[CUSTOMER][NEUTRAL] Oh yes. One moment. It's 01603030 ML 8.
[AGENT][NEUTRAL] OK, thank you very much. And verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And the date of birth?
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you very much for the verification process and you're calling for benefits for outpatient and give me one moment please.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh, this particular policy actually has termed, and it turned as of [PII]. If you would bear with me, I can check to see if there is an active policy.
[AGENT][NEUTRAL] For this remember one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me provide you with the correct policy number when you're ready for that.
[CUSTOMER][NEUTRAL] OK, allow me a moment.
[CUSTOMER][NEUTRAL] OK, give me one moment.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm
[CUSTOMER][POSITIVE] OK, let me know I'm ready.
[AGENT][NEUTRAL] OK. It is 254-496-3.
[AGENT][NEUTRAL] ML 9
[CUSTOMER][NEUTRAL] Uh, you said 254-496-3 L?
[AGENT][NEUTRAL] ML 9.
[CUSTOMER][NEUTRAL] OK, and I know what is the effective date?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII] and this policy shows active for the member.
[AGENT][NEUTRAL] And let me check those benefits for you for outpatient. Would this be for an office setting or facility charge?
[CUSTOMER][NEUTRAL] It's in office.
[AGENT][POSITIVE] Oh that's OK, thank you one moment.
[CUSTOMER][NEUTRAL] Let me let me.
[CUSTOMER][NEUTRAL] This one will be 93,980.
[AGENT][NEUTRAL] OK, and I do apologize this policy does not cover for an office visit. That could be with a PCP or specialist. Again, that is not a covered benefit, an office visit.
[CUSTOMER][POSITIVE] OK, excellent. Allow me a moment.
[AGENT][NEUTRAL] OK, is there anything else I can help you with, please?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yes, I have other questions. So, um, just to confirm, you said, the office visit, um, for the specialist is not covered.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Perfect, OK. And then, um, which is the amount, the limit of the policy?
[AGENT][NEUTRAL] OK, for outpatient benefits for this member, one moment.
[AGENT][NEUTRAL] OK, for outpatient, please note verification of benefits provided does not guarantee payment. For outpatient, the max for the year is $1250.
[AGENT][NEUTRAL] And that's for the calendar here.
[CUSTOMER][NEUTRAL] OK. It is 125, 1250, 1250. And do you have any, oh sorry, patient.
[CUSTOMER][NEUTRAL] Any has any satisfied amount?
[AGENT][NEUTRAL] I'm sorry, if you could ask that one more time? I'm sorry.
[CUSTOMER][NEUTRAL] Oh, if the patient met any amount?
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] No, not for this year.
[CUSTOMER][NEUTRAL] OK. So for a patient diagnosis service, the policy cover of 1250, and at this time, Serraed. OK. And office visits are not covered. Excellent. And, do you have a reference number for me?
[AGENT][NEUTRAL] We do not provide reference numbers. You can use my name in today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much. Have a wonderful day. Bye-bye.
[AGENT][POSITIVE] You're welcome. Thank you for calling AP I'll take care as well. Mm bye.
[CUSTOMER][NEUTRAL] Bye.