AccountId: 011433970860
ContactId: b856cc79-e2ad-4850-8a81-8ed412725d40
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 243070 ms
Total Talk Time (AGENT): 131713 ms
Total Talk Time (CUSTOMER): 92220 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/06/b856cc79-e2ad-4850-8a81-8ed412725d40_20250606T18:02_UTC.wav
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[AGENT][POSITIVE] Thank you for calling ATL. This is. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm sorry, your voice is cutting in and out.
[AGENT][NEUTRAL] Oh, my name is [PII]. What can we help you with today?
[CUSTOMER][NEUTRAL] [PII]. Hi [PII]. My name is [PII]. I am calling from the University of Virginia Medical Center. I am trying to verify benefits um for a patient coming in for an appointment.
[AGENT][NEUTRAL] Sure, yeah, I could check those benefits for you. Um, I'm sorry, you said your name was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK and then can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And do you have that policy number?
[CUSTOMER][NEUTRAL] Policy number is 025730777.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] Uh, the patient is [PII], [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Perfect, thank you for verifying that. Uh, so this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays, and we're reading to look at inpatient or outpatient benefits for this member.
[CUSTOMER][NEUTRAL] It's excuse me, outpatient specialist office visit.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Offices, OK, um, of course I will let you know verification of coverage is not a guarantee of payment for claims, so this policy does not offer any coverage for office visits or treatment received in office unless it is specifically uh cancer treatment.
[CUSTOMER][NEUTRAL] All right, let's see.
[CUSTOMER][NEUTRAL] So it's palliative care, which is like pain control.
[AGENT][NEUTRAL] OK, so that would not be a covered benefit under this policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, so for general, just so I can note on my referral, what kind of visits does it cover? Just cancer?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] As far as office visits of any kind, yes, um, and that even then the office visit wouldn't be covered, it's the treatment that's received and that's specifically for cancer. Uh, the extent of this policy for outpatient, I'm sorry.
[CUSTOMER][NEUTRAL] So this is
[CUSTOMER][NEUTRAL] Uh, when you say treatment, you're talking about like procedures?
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] So it only covers cancer treatment procedures.
[AGENT][NEUTRAL] In office, yes, they do have other benefits for um outpatient that's going to be more along the lines of um hospital, uh emergency room, let's see, urgent care, uh, surgeries that have physical therapy benefits, but nothing as far as.
[CUSTOMER][NEUTRAL] So this is kind of like a cancer a cancer policy?
[AGENT][NEUTRAL] No, this is a secondary medical policy, um, but it is supplemental.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] They have a lot of other coverage that's the only coverage that's offered in office is for cancer treatment. All of their other outpatient benefits don't necessarily have to be for cancer, but would not be covered in office, in an office setting.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So only in office treatment, um, only in office coverage is cancer treatment.
[AGENT][NEUTRAL] The treatment of cancer. Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, um.
[CUSTOMER][NEUTRAL] And um can I get a reference number for the call?
[AGENT][NEUTRAL] Sure, that would just be my first name, last initial, and today's date. Uh so my name is spelled [PII] Was there anything else I could help you with?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] All right, that's it thank you so much.
[AGENT][POSITIVE] Oh thanks for calling APO. Have a great rest of your day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.