AccountId: 011433970860
ContactId: ce70df35-41e6-440a-a3fa-a2c666069231
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 225360 ms
Total Talk Time (AGENT): 88697 ms
Total Talk Time (CUSTOMER): 97038 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/25/ce70df35-41e6-440a-a3fa-a2c666069231_20250425T12:34_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning, [PII]. I was calling to um verify coverage.
[AGENT][POSITIVE] OK, I can help you with your name.
[CUSTOMER][NEUTRAL] My name is [PII]. My last name initial is [PII].
[AGENT][NEUTRAL] OK, and is this for service in a doctor's office or outpatient facility hospital?
[CUSTOMER][NEUTRAL] Outpatient, outpatient coverage.
[AGENT][NEUTRAL] For a hospital facility?
[CUSTOMER][NEUTRAL] Oh, we build office.
[AGENT][NEUTRAL] OK. And what's the policy number?
[CUSTOMER][NEUTRAL] Um, yes, it is 02497681 ML8.
[AGENT][NEUTRAL] And
[AGENT][POSITIVE] Thank you and what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Um, [PII] [PII].
[AGENT][NEUTRAL] Thank you. So I show the policy effective date is [PII]. The policy is active.
[AGENT][NEUTRAL] And so is this an office visit or is it treatment in an office?
[CUSTOMER][NEUTRAL] Treatment in an office.
[AGENT][NEUTRAL] What type of treatment is it?
[CUSTOMER][NEUTRAL] It's a diagnostic facility. I just need her outpatient benefits.
[AGENT][NEUTRAL] I know it, but I need to know specifically the place of service in order to quote you the correct.
[CUSTOMER][NEUTRAL] I've been working here for years and you're the first person to have ever asked me so many specific questions just to give me her outpatient benefit is $500 a day or $1000 you know, and she's used this, that and the third, so.
[AGENT][NEUTRAL] Well, that's OK. I just wanna make sure that I provide you the correct information.
[AGENT][NEUTRAL] Yeah, I, I understand.
[AGENT][NEUTRAL] I understand the maximum outpatient benefit.
[CUSTOMER][NEUTRAL] I don't know how to answer your questions, to be honest with you. She's, we are a diagnostic facility. We bill as an office though, and
[CUSTOMER][NEUTRAL] We provide mammograms, bone densities, breast ultrasounds, thyroid ultrasounds, things like that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So for an ultrasound.
[CUSTOMER][NEUTRAL] That's what she's coming for a mammogram and a possible breast ultrasound and a bone density.
[AGENT][NEUTRAL] OK, so that would be under the outpatient benefit, which is up to $7900.
[CUSTOMER][POSITIVE] Yes, that's what I asked for.
[AGENT][NEUTRAL] Mhm. Up to 7000.
[CUSTOMER][NEUTRAL] How much?
[CUSTOMER][NEUTRAL] Up to 7000, has she used any of her 7000?
[AGENT][NEUTRAL] It's up to $7900 that is per calendar year.
[AGENT][NEUTRAL] And information provided is verification. It doesn't guarantee payment of a claim. I do not show any of that benefit used at this time either. And did you have any other questions?
[CUSTOMER][NEUTRAL] Has she used it?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is it [PII]? How do I spell your name?
[AGENT][NEUTRAL] The correct spelling of my name is [PII].
[AGENT][NEUTRAL] ONYA first initial last name is [PII], and you'll use my name and today's date.
[CUSTOMER][POSITIVE] That was all my questions. Thank you so much for your help. You have a lovely day.
[AGENT][POSITIVE] As reference for today's call. You're welcome, [PII]. Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Bye bye.