AccountId: 011433970860
ContactId: b69a2e9e-8ef9-4f90-b48e-067b4f65bc75
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 440739 ms
Total Talk Time (AGENT): 180266 ms
Total Talk Time (CUSTOMER): 183659 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/10/b69a2e9e-8ef9-4f90-b48e-067b4f65bc75_20250210T14:02_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm giving you a call from a specialist office. The patient gave me this card as a secondary. I'm trying to see if you guys, what, what do you guys pick up for secondary for a specialist office.
[AGENT][POSITIVE] I have a policy num a callback number for you, [PII], and then that policy number and I'll be able to assist you.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] The policy number is where are you?
[CUSTOMER][NEUTRAL] OK, outpatient benefit OK 02141819 ML 8.
[AGENT][NEUTRAL] And can you verify that patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Verify the date of birth again for me.
[CUSTOMER][NEUTRAL] [PII]. Let me be sure let me get out of this what I'm in.
[AGENT][NEUTRAL] Because we don't have that in the system.
[CUSTOMER][NEUTRAL] Hold on.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Hold on one minute let me get out of this.
[CUSTOMER][NEUTRAL] OK, [PII], yeah, we have [PII]. Let me look on his ID.
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Um, can you verify the
[CUSTOMER][NEUTRAL] And they have it's [PII]
[AGENT][NEUTRAL] Yep, that's what I have is the name, but the date of birth is incorrect. Give me one moment. Could you, do you have the last four of his social?
[CUSTOMER][NEUTRAL] Uh, I can get it. Hold on, hold on one moment, OK?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Hold on. A member of our staff will be with you shortly.
[AGENT][NEUTRAL] Let me look on
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] With 6 seasoned physicians, you can rest assured that neuromedics can treat the most common enlarged prostate issues to the most difficult prostate and bladder cancers, from nocturia and overactive bladder to neurogenic bladder and infertility. Our specialists are equipped with the latest [PII].
[AGENT][NEUTRAL] [PII] thank you. I'm pulling up the application to see if we made an error.
[AGENT][NEUTRAL] In regards to the date of birth.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah, because that's what's on his social.
[CUSTOMER][NEUTRAL] And on the insurance.
[AGENT][NEGATIVE] Because it's not matching in the system what you provided me.
[AGENT][NEUTRAL] May I place you on a brief hold while I contact customer service.
[CUSTOMER][NEUTRAL] Sure
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Deering.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[AGENT][NEUTRAL] Hey [PII], how are you doing?
[CUSTOMER][POSITIVE] Doing good how are you?
[AGENT][NEUTRAL] I'm great thanks for asking [PII]. This is [PII] in the claims department. Could you pull up a policy, uh application to verify the patient's date of birth to see if we made a typo on it because it's not allowing to pull it up.
[CUSTOMER][NEUTRAL] Sure. Uh.
[CUSTOMER][NEUTRAL] What is the policy number?
[AGENT][NEUTRAL] It's 249-745-1. It's 249-7451.
[CUSTOMER][NEUTRAL] Alright, give me just a second so I can pull it up.
[CUSTOMER][NEUTRAL] Is it for kite?
[CUSTOMER][NEUTRAL] Thompson.
[AGENT][NEUTRAL] Piano
[AGENT][NEUTRAL] 2497457
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] 745 0 I got it I got the wrong last email wrong number wrong, OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I probably gave it to you wrong, it's Monday.
[CUSTOMER][NEUTRAL] It's the starting day.
[CUSTOMER][NEUTRAL] Start in the week. OK. Let's see.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Let's
[AGENT][NEUTRAL] On the date of birth, it says in the system we have [PII], but the provider called to verify benefits and she gave me [PII]. So I tried to pull up the application, but I'm not finding it in the system.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK it says there's a senses here.
[CUSTOMER][NEUTRAL] 0100, OK, we have to go really back further with this policy. Give me just a minute because there's a lot of them here.
[CUSTOMER][NEUTRAL] I'll go one by one.
[AGENT][NEUTRAL] They probably need to do the, probably need to do the very first one.
[CUSTOMER][POSITIVE] Mhm, yeah, I'll try to get that one.
[AGENT][NEUTRAL] The application may be attached to that one.
[AGENT][NEUTRAL] 1303.
[AGENT][NEUTRAL] That's.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, it is. I was on a new one.
[CUSTOMER][NEUTRAL] Uh, yes, I do see it's 920 of the 88. I can go ahead and make the correction.
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][POSITIVE] And you're welcome.
[AGENT][POSITIVE] Have a good one.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Thank you for holding, [PII], and I apologize for the inconvenience. So date of birth is a typo in our system. Someone is correcting it now, but his, and thank you for your patience, but his policy has been active since [PII], and let me give you the correct policy number. Let me know when you're ready for it.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] I'm ready.
[AGENT][NEUTRAL] It's 249.
[AGENT][NEUTRAL] 7457. It's 249-7457. And what was, what was the place of service?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Specialist office 11.
[AGENT][NEUTRAL] So the office visit itself is not covered, however, the treatment received in the office falls under his outpatient benefits.
[AGENT][NEUTRAL] Of $2500 per calendar year and this is not a oh he do have the office visit, right? I'm sorry, the treatment received in the office is under his outpatient benefits of $2500 per calendar year. Then he has office visit riders with $50 per visit for um.
[AGENT][NEUTRAL] Specialist office visit and $25 per visit for a regular office visit.
[CUSTOMER][NEUTRAL] Oh, OK. Any uh ref
[AGENT][NEUTRAL] And this is not a guaranteed benefits, just a disclaimer of the policy coverage.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Your your phone is going in and out. I'm sorry.
[AGENT][NEUTRAL] I gave the disclaimer. I said this is not a guarantee of benefits, just a disclaimer of the policies coverage. Did you hear me when I gave you the benefits or do you need me to repeat them?
[CUSTOMER][NEUTRAL] Yes ma'am, no, no, no, you were going in and out, but I was able to hear you, um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The um and no referrals or anything are required?
[AGENT][NEUTRAL] No, this is a gap insurance.
[CUSTOMER][NEUTRAL] OK, and just a spell your name for me please?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the reference number for this call.
[AGENT][NEUTRAL] We don't provide those [PII], however, you can use my name and today's date as a reference.
[CUSTOMER][POSITIVE] OK, thank you so much [PII] have a great day.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. Have a good day as well, [PII]. Goodbye.
[CUSTOMER][NEUTRAL] Bye bye.