AccountId: 011433970860
ContactId: cf890177-6e92-43a4-b9bb-96d4455c9025
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 164940 ms
Total Talk Time (AGENT): 80049 ms
Total Talk Time (CUSTOMER): 48883 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/cf890177-6e92-43a4-b9bb-96d4455c9025_20250528T21:16_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], good afternoon. I'm calling to verify the members benefits for the plan that we have.
[AGENT][POSITIVE] OK, well, I can definitely help you with the benefits. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, that's [PII]. Quick call back is [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Uh yes policy number one moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, give me a second here.
[CUSTOMER][NEUTRAL] I have here 01823109 ML8.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] date of birth of [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And I am showing the policy is active. It's been effective since [PII].
[AGENT][NEUTRAL] And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] I just want to go over the uh the benefits he has for an MRI. He's doing it in an outpatient hospital.
[AGENT][NEUTRAL] Alright, so the policy will pay up to $2000 per calendar year for outpatient expenses. That does include diagnostic testing in a hospital outpatient facility or MRI facility. Um, did you want me to see if any of the two, any of the two has been used?
[CUSTOMER][NEUTRAL] OK, so please.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEGATIVE] And so far he has not, um, she has not used, sorry, he has not used any of the benefits for [PII].
[CUSTOMER][NEUTRAL] OK, so he still has the full amount left, OK, and you can use that towards his deductibles, copays, things like that, right?
[AGENT][NEUTRAL] Right, we pay towards the copay, deductible and co-insurance of coverage charges after primary.
[CUSTOMER][NEUTRAL] OK great and is there a reference? Oh wait, um, do you mind giving me the claims address for the patient?
[AGENT][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Great thank you so much um and you you want to spell your name?
[AGENT][NEUTRAL] Sure, my name is [PII], [PII] initial to my last name is [PII].
[CUSTOMER][POSITIVE] Got it and thank you so much for your help.
[AGENT][POSITIVE] You're welcome and thanks for calling APL. I hope you have a good day.
[CUSTOMER][NEUTRAL] Likewise bye bye.
[AGENT][POSITIVE] Thank you. Bye bye.