AccountId: 011433970860
ContactId: c05d706e-b1ca-4eb4-82e3-fe21e83a6359
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 192029 ms
Total Talk Time (AGENT): 97668 ms
Total Talk Time (CUSTOMER): 62928 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/c05d706e-b1ca-4eb4-82e3-fe21e83a6359_20250326T14:26_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning [PII]. This is [PII], and I'm calling you from Mickey for Urology Clinic, and I am calling on behalf of a mutual patient, Mr. [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I just needed to find out a few details about his insurance that he has here.
[AGENT][POSITIVE] Well, [PII], it would be my pleasure to assist you with insurance information. What is a good callback number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII]. Thank you, [PII]. And what is the policy number?
[CUSTOMER][NEUTRAL] His policy number is 02511320.
[AGENT][NEUTRAL] And [PII], what is the patient's full name and date of birth?
[CUSTOMER][NEUTRAL] [PII] date of birth is [PII].
[AGENT][NEUTRAL] All right, thank you. And I can help you with eligibility and benefits if needed. His policy is active. Effective date is [PII].
[AGENT][NEUTRAL] And this is a limited indemnity policy.
[AGENT][NEUTRAL] And how else can I assist you?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um, well, we have a CPT code. I didn't know if that was possibly something that you could help with as well to see if it is covered under this policy.
[AGENT][NEUTRAL] Yeah, is it for an office visit or what type of service would it be for?
[CUSTOMER][NEUTRAL] Um, well, it is gonna be in office surgical procedure.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Now, he does have benefits for an office visit.
[AGENT][NEUTRAL] Any services in the doctor's office, that benefit amount is $75 per day, with a maximum of 6 days per calendar year.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that is for the visit or procedures.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK, so they'll pay up to $75 for 6 visits.
[AGENT][NEUTRAL] Right, the indemnity amount is $75. Now that is a verification of coverage and not a guarantee of payment.
[AGENT][NEUTRAL] And is there anything else I can help you with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, is there any coinsurance or percentage on that that.
[CUSTOMER][NEUTRAL] Needs to be added into that?
[AGENT][NEUTRAL] No, ma'am, there's no deductible, co-pay or co-insurance on this policy. It is an indemnity amount that we pay of $75.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right well thank you so much for your time today and you have a wonderful day and what was your name again?
[AGENT][NEUTRAL] My name is [PII]
[AGENT][NEUTRAL] First initial last name, [PII].
[CUSTOMER][NEUTRAL] OK, and is there a call for reference?
[AGENT][NEUTRAL] Yes ma'am, it would be my name in today's date.
[CUSTOMER][POSITIVE] OK perfect thank you so much you have a wonderful day today.
[AGENT][POSITIVE] My pleasure to help you with those benefits, [PII]. If there's nothing else I can help you with, I hope you have a wonderful day as well. Thank you for calling APL.
[CUSTOMER][POSITIVE] All right thanks bye bye.
[AGENT][NEUTRAL] Bye-bye.