AccountId: 011433970860
ContactId: d906c06a-8af7-4af1-bb7d-3bd4cceb4193
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 165880 ms
Total Talk Time (AGENT): 81120 ms
Total Talk Time (CUSTOMER): 48998 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/d906c06a-8af7-4af1-bb7d-3bd4cceb4193_20250228T21:28_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] Yes, hi, good afternoon. My name is [PII]. I'm calling from CMS Diagnostics.
[CUSTOMER][NEUTRAL] I wanted to know um if uh one mutual patient have coverage for uh a a cardiac PET scan. He's having, uh, his appointment is on Monday with us.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. OK. Sure, I can assist you with that information, Miss [PII]. 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] 02519166
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK, perfect. Thank you. And 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. Um, we have an effective date of [PII]. It is active at the moment and this is one of our secondary supplemental plans for the major medical.
[AGENT][NEUTRAL] Um, let's see.
[AGENT][NEUTRAL] So this is gonna be for diagnostics. Let me pull up.
[AGENT][NEUTRAL] Be one moment.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] And again this is not a guarantee of payment, just a verification of coverage. And with this one, we have a calendar year maximum I'm sorry, it's gonna be a calendar day. So this is a daily benefit of $300 for outpatient service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, um, OK, let me, let me just, let me be clear, so, uh, let's see, if he do it on Monday, he has a $3 300 dollars $300 coverage.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Correct. We cover up to $300 of the amount uh the major medical applied towards the deductible copayment or co-insurance.
[CUSTOMER][POSITIVE] OK. OK. Thank you so much for your help.
[AGENT][POSITIVE] You're welcome. Is there anything else I may help you with today?
[CUSTOMER][POSITIVE] No, thank you so much.
[AGENT][POSITIVE] You're welcome. Thank you for calling APL. Have a good day. Familiar. Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] You too, bye.