AccountId: 011433970860
ContactId: bc748c36-8729-40ed-a221-599e244e91f5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 292920 ms
Total Talk Time (AGENT): 117574 ms
Total Talk Time (CUSTOMER): 76357 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/bc748c36-8729-40ed-a221-599e244e91f5_20250211T19:18_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] Uh, hi, [PII]. My name is [PII]. Um, uh, I was calling to get, um, diagnostic testing benefits for a specialist.
[AGENT][NEUTRAL] Diagnostic testing done in a specialist office coverage?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] OK, well, I'll be more than happy to assist you with the coverage and are you the insured or you're calling from a provider's office?
[CUSTOMER][NEUTRAL] Provider's office.
[AGENT][POSITIVE] Thank you for that. And may I have a good contact number in case we're disconnected and your and the policy number, sorry.
[CUSTOMER][NEUTRAL] Mhm. [PII] um and that's my direct line.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Policy number is 02341573.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Mhm. [PII], I guess that's how you say it, [PII] or day [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 the policy is active, it's been effective since July, I'm sorry, [PII]. And um what type of benefits you said diagnostic testing in a physician's office?
[CUSTOMER][NEUTRAL] Yes, ma'am, a specialist.
[AGENT][NEUTRAL] OK, specialist, hold on one moment.
[AGENT][NEUTRAL] OK, so the policy will pay up to $5000 per calendar year?
[AGENT][NEUTRAL] Um, did you want me to see if any has been used for the outpatient benefits?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] And so far for this year, they have not used any of the benefits.
[CUSTOMER][NEUTRAL] Um, so what type of policy is this? Is this a limited policy?
[AGENT][NEUTRAL] No, so this is their Medlink um supplemental insurance. So we pay towards the copay, deductible and co-insurance of coverage charges after primary, which I'm showing as Blue Cross Blue Shield of Texas.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] All righty.
[AGENT][NEUTRAL] Alright, well, was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] I'm sorry, you told me your name and
[CUSTOMER][NEUTRAL] I didn't write it down.
[AGENT][NEUTRAL] Oh, it's OK. My name is [PII] [PII].
[CUSTOMER][NEUTRAL] And [PII], do you get a reference number?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] All right, Ms. [PII], thank you so kindly for your help.
[AGENT][POSITIVE] You're welcome and thanks for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] All right, bye-bye. Oh, Ms. [PII], and, and this will cover like, like you say if they're in the office, $5000 up.
[AGENT][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Up to $5000.
[CUSTOMER][NEUTRAL] After the primary pays in a doctor's office, correct?
[AGENT][NEUTRAL] Oh, well, hold on one second. Let me go back to, hold on one moment.
[AGENT][NEUTRAL] Let me pull up there.
[AGENT][NEUTRAL] I'm just waiting for the full um the full documents to populate. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let's see if it specifies physician. So for this policy, no, so there is diagnostic testing, but it will have to be in a hospital outpatient facility or MRI facility. They don't have any in-office coverage on this policy.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] Got it. I'm good. I thought to ask that question. Thank you so much, Miss [PII].
[AGENT][POSITIVE] I'm glad you did. You're welcome.
[CUSTOMER][POSITIVE] You have a great one, OK?
[AGENT][POSITIVE] Thank you you also, and thanks for calling APL.
[CUSTOMER][NEUTRAL] All righty. Bye-bye.
[AGENT][NEUTRAL] Bye bye.