AccountId: 011433970860
ContactId: c60f7b02-9473-4d7d-af81-c845372bec85
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 204369 ms
Total Talk Time (AGENT): 86735 ms
Total Talk Time (CUSTOMER): 63111 ms
Interruptions: 0
Overall Sentiment: AGENT=2.7, CUSTOMER=2.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/06/c60f7b02-9473-4d7d-af81-c845372bec85_20250606T14:02_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. My name is [PII]. I'm calling from a facility because I need to verify benefits for a member, please.
[AGENT][POSITIVE] OK, well, I can definitely help you with the benefits. And [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] And the member's ID is [PII]. [PII].
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes, her name is [PII]. Um, she has two last names. I'm not sure which one you guys have, um, [PII], and date of birth, [PII].
[AGENT][NEUTRAL] Thank you for that. And all the information provided is a verification of benefits, not a guarantee of payment. So I am showing the policy is active. It's been effective since, hold on.
[AGENT][NEUTRAL] Since I'm sorry, since [PII].
[CUSTOMER][NEUTRAL] Oh, perfect. And would the member have any um outpatient hospital benefits for diagnostics?
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I'm just waiting for the benefits to come up here hold on one moment.
[CUSTOMER][NEUTRAL] It's OK. I can wait.
[AGENT][NEUTRAL] So for outpatient, the policy will pay up to $1500 per calendar year. That does include diagnostic testing in a hospital outpatient facility or a freestanding outpatient surgery center, um.
[AGENT][NEUTRAL] Hold on one moment. She also has the office treatment writer, so if any of this is done in office, um, as long as it's not cosmetic, the office treatment writer should cover it or could cover it up to that 1500 per year.
[CUSTOMER][NEUTRAL] Oh, OK, perfect. And are you able to see if she's used any of those 1500?
[AGENT][NEUTRAL] Sure, let me check for you hold on one moment.
[AGENT][NEUTRAL] Um, she's used $750 so she has $750 left for the year.
[CUSTOMER][POSITIVE] OK, perfect. Thank you so much. Um, may I have the first letter of your last name and a call reference number, please?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. And again, that's [PII], first initial to my last name is [PII].
[CUSTOMER][POSITIVE] Perfect. Thank you so much. I hope you have a great rest of your day.
[AGENT][POSITIVE] Thank you, [PII]. You also, was there anything else I could assist you with today?
[CUSTOMER][POSITIVE] That would be all. Thank you.
[AGENT][POSITIVE] Alright, thanks for calling APL have a great day.
[CUSTOMER][POSITIVE] Thank you you as well bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.