AccountId: 011433970860
ContactId: c5406dfd-4cce-4ae8-8ac6-8d7bf3c08c85
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 294320 ms
Total Talk Time (AGENT): 130379 ms
Total Talk Time (CUSTOMER): 57488 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/02/c5406dfd-4cce-4ae8-8ac6-8d7bf3c08c85_20250602T17:23_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from Pediatric Endocrine. I'm trying to see, uh, I'm trying to verify benefits and eligibility for a patient and see if our doctors are participating provider with the insurance.
[AGENT][POSITIVE] OK. Well, I'll be more than happy to help you with the eligibility and the benefits. And [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] I just have it just showed a group number so all I have is 17768.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And may I have the member's first and last name?
[CUSTOMER][NEUTRAL] It would be for [PII]
[AGENT][NEUTRAL] And can you verify the member's date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And all the information provided is a verification of benefits, not a guarantee of payment. So the policy number is 143.
[AGENT][NEUTRAL] 3096.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The policy has been active since [PII].
[AGENT][NEUTRAL] And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] I'm trying to see if it picks up any copays or deductibles from the primary.
[AGENT][NEUTRAL] OK, so are you all considered an inpatient facility or outpatient?
[CUSTOMER][NEUTRAL] We are neither we are a specialist office.
[CUSTOMER][NEUTRAL] Or endocrinology.
[AGENT][NEUTRAL] OK, so for this
[CUSTOMER][NEUTRAL] So it would be an office setting.
[AGENT][NEUTRAL] OK, so for this policy, that would be under outpatient. Um, so the outpatient would be up to $500 per calendar day that we would pay towards those expenses, the office visit. Um, hold on one moment though, let me see if this has
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I just want to check and see if this has a deductible. Hold on one second.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Alright, I'm just waiting for the benefits to the full policy to populate. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Do you mind if I place you on just a brief hold?
[CUSTOMER][NEUTRAL] That's fine.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, wait a minute.
[AGENT][NEUTRAL] Those were previous.
[AGENT][NEUTRAL] Coverages, why it was now.
[AGENT][NEGATIVE] So there's no deductible. There's also, also no.
[AGENT][NEGATIVE] No, they don't have office coverage.
[AGENT][NEUTRAL] OK, hello [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Thank you so much for holding. I apologize for that wait. I just wanted to double check the um coverage that I gave. So yes, for this policy, there's no like office treatment rider or um office fee rider. So this policy does not cover the in-office setting.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, was there any, OK. My name is [PII], first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] And what was your name?
[CUSTOMER][NEUTRAL] And can I have a reference number for this call?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name and today's date.
[CUSTOMER][POSITIVE] OK, sounds good thank you very much.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Nope, that would be it thank you.
[AGENT][POSITIVE] Alright, thanks for calling APO bye bye.
[CUSTOMER][NEUTRAL] Bye bye.