AccountId: 011433970860
ContactId: c4261ed4-d001-42a2-b9e1-5032df74c4b9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 185809 ms
Total Talk Time (AGENT): 85120 ms
Total Talk Time (CUSTOMER): 61906 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/c4261ed4-d001-42a2-b9e1-5032df74c4b9_20250407T20:30_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, good afternoon. So, um, I'm calling from West Kendall BGYN. I have a patient that, um, I would like to verify her coverage please.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] And
[AGENT][POSITIVE] Yeah, OK, sure, yes, I can assist you with benefits. May I have your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK, and may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] It will be 02221666.
[CUSTOMER][NEUTRAL] ML 8.
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] So, can I have the first initial to your last name if it's possible?
[AGENT][NEUTRAL] Sure, it's [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're welcome. And may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII], date of birth I have [PII].
[AGENT][NEUTRAL] OK, thank you. And you said you're looking for benefits and this is for office specialists?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK. Before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. And this is one of our secondary supplemental plan to the major medical. And with this one, let's see, we cover office treatments. We do not cover the office visit. Uh, the office treatment is subject to the outpatient maximum which is 3500.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Per covered person per calendar year.
[CUSTOMER][NEUTRAL] OK, 3500 max per calendar year.
[CUSTOMER][NEUTRAL] Um, has she used any of it this year?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, let me check on that for you one moment.
[AGENT][NEUTRAL] As of today, she has used $346.86.
[CUSTOMER][NEUTRAL] Use 300.
[CUSTOMER][NEUTRAL] And how much?
[AGENT][NEUTRAL] $346.86.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][NEUTRAL] Perfect, um, so do I get a reference number for this call or not really?
[AGENT][NEUTRAL] No, we don't have reference numbers. You can use my name in today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect. OK, thank you so much for all your help.
[AGENT][NEUTRAL] OK there
[AGENT][POSITIVE] You're welcome and thank you for calling APL. You have a good afternoon, Miss [PII].
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. OK.