AccountId: 011433970860
ContactId: b2a50fa4-afeb-4a1b-b6bb-5a305e40b2de
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 155699 ms
Total Talk Time (AGENT): 80943 ms
Total Talk Time (CUSTOMER): 42842 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/b2a50fa4-afeb-4a1b-b6bb-5a305e40b2de_20250325T18:03_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] calling from Lee Memorial, and I'm calling for benefits prior authorization requirements.
[AGENT][POSITIVE] OK, well, I'll be more than happy to assist you with the benefits and the prior offer and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Sure, I have.
[CUSTOMER][NEUTRAL] 02588768
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you for that, and all the information provided is a verification of benefits, not a guarantee of payment. I am showing that the policy is active, it's been effective since [PII]. Um, none of the APL policies require prior off because we're not a major medical. And then what type of benefits did you want to go over?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] She has an ultrasound on the schedule.
[AGENT][NEUTRAL] You're considered outpatient?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, um, so for the outpatient benefits, the policy would pay, hold on.
[AGENT][NEUTRAL] Outpatient.
[AGENT][NEUTRAL] It's combined. OK, up to $2000 per calendar year. Did you want me to see if any has been used for the year? Are you OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Please.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEGATIVE] So far for [PII], no one has, they haven't used any of their benefits.
[CUSTOMER][NEUTRAL] OK, so it just picks up whatever the primary doesn't pay up to $2000 annually?
[AGENT][NEUTRAL] Well, kind of, we pay towards the copay, deductible and co-insurance after primary of coverage charges. So it might not be everything, but those three we pay towards.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK and then is there a reference number?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date and again that's [PII], first initial to my last name is [PII].
[CUSTOMER][POSITIVE] OK. Thank you, [PII].
[AGENT][POSITIVE] You're welcome, [PII]. Was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] That should do it. You have a great day.
[AGENT][POSITIVE] Alright, you also thanks for calling APL bye bye.
[CUSTOMER][NEUTRAL] OK, bye.