AccountId: 011433970860
ContactId: c2967340-590a-4c48-822a-5062dd625c62
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 251960 ms
Total Talk Time (AGENT): 84727 ms
Total Talk Time (CUSTOMER): 144429 ms
Interruptions: 3
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/c2967340-590a-4c48-822a-5062dd625c62_20250523T18:55_UTC.wav
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[AGENT][NEUTRAL] Good afternoon, thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. My name is [PII]. I'm calling from a provider's office, urology specialist, and I need to, um, I need to get benefits in one of your members, uh, basically to see if the insurance, uh, will cover any of the, you know, the debt that he's gonna have for biopsy at the office.
[CUSTOMER][NEUTRAL] Can you help me with that?
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Sure, yes, I can assist you with benefits, Miss [PII]. And may I have, you're welcome. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Thank you so much.
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] The policy number is 02565764.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][POSITIVE] OK, perfect. Thank you.
[CUSTOMER][NEUTRAL] And I do have I.
[AGENT][NEUTRAL] All right, and before I give you any better mhm go ahead. Mhm.
[CUSTOMER][NEUTRAL] I'm sorry, I do have the codes for the biopsy, OK?
[AGENT][NEUTRAL] OK, it's fine. Um, I'm sorry, uh, let's see, this is not a guarantee of payment, just a verification of coverage. And this is just a disclaimer, and this is one of our secondary supplemental plan to the major medical.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And let's see.
[CUSTOMER][NEUTRAL] I mean we have the verification from uh his primary insurance which is United and since his deductible is not being met, the patient will be responsible to pay uh for the biopsy 1 $121.82. Now when I call the patients um at home to let you know, to let him know about the, you know, the payment that he's gonna have to be.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] doing on on Tuesday, his wife told me, OK, I need you to call my his gap insurance to see if they will cover any amount of that. I don't know. That's why I'm calling.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright
[AGENT][NEUTRAL] OK, and it doesn't look like it covers any office treatment, but let me double check, OK?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Like.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And who am I speaking with?
[AGENT][NEUTRAL] This is [PII] with APL.
[CUSTOMER][NEUTRAL] Your name is [PII]?
[AGENT][NEUTRAL] So, so.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] They.
[AGENT][NEUTRAL] So, so as well.
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I believe that
[AGENT][NEUTRAL] urgent care emergency, mental surgery, speech therapy, physical therapy.
[AGENT][NEUTRAL] And that is.
[AGENT][NEGATIVE] Yeah, I don't see any benefits for office under this one.
[AGENT][NEUTRAL] And this one doesn't cover office.
[CUSTOMER][NEUTRAL] Oh, OK. Because it's, it's gonna be done at the office.
[AGENT][NEUTRAL] Mhm. Yes.
[CUSTOMER][NEUTRAL] So his benefits basically is at the hospital or at the diagnostic center?
[AGENT][NEUTRAL] Yes, any outpatient facility.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] [PII] but hello.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, ma'am. Thank you so much. OK.
[AGENT][POSITIVE] You're welcome. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Yeah