AccountId: 011433970860
ContactId: e0a15c15-331d-4e43-9ec4-097e7fc5ae74
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 151690 ms
Total Talk Time (AGENT): 52809 ms
Total Talk Time (CUSTOMER): 66405 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/21/e0a15c15-331d-4e43-9ec4-097e7fc5ae74_20250521T18:43_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, I'm calling from a provider's office to verify coverage on a member, please.
[AGENT][POSITIVE] OK, I can help you with benefits. Can I get your name and a good callback number, please?
[CUSTOMER][NEUTRAL] My name is [PII] and my call back number is [PII].
[AGENT][NEUTRAL] OK, thank you, [PII]. And do you have a policy number for that patient?
[CUSTOMER][NEUTRAL] It's 0255.
[CUSTOMER][NEUTRAL] 64
[CUSTOMER][NEUTRAL] 24 M as in Mary, L as in Laura number 8.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] And his date of birth is [PII].
[AGENT][NEUTRAL] Uh, it looks like this policy is active and effective [PII]. And is this gonna be for office visit or outpatient services or?
[CUSTOMER][NEUTRAL] He is here in our office to do uh 2 ultrasounds.
[CUSTOMER][NEUTRAL] In the office, so I wanted to check if he has coverage for that.
[AGENT][NEUTRAL] OK. So the ultrasounds will be in, in the physician's office. Is that right?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] This is not a guarantee of payment. It's a basic outline of the policy. Uh, looks like the outpatient benefit maximum pays up to $8700 per calendar year.
[AGENT][NEUTRAL] And that does include treatment and procedure performed in office, just not the actual office visit itself.
[CUSTOMER][POSITIVE] OK, so it does include procedures in the office. OK, perfect.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] The only exception will be the the actual office visit.
[AGENT][NEUTRAL] That's correct. That would be not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And you do, um, and what is it that you pick up from the primary insurance?
[AGENT][NEUTRAL] A deductible co-pay or co-insurance up to 8700.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK perfect perfect thank you so much that's all I needed um you say your name is [PII], right?
[AGENT][POSITIVE] Yes, that's right.
[CUSTOMER][NEUTRAL] [PII], is there a reference number for our call?
[AGENT][NEUTRAL] That's my name and today's date.
[CUSTOMER][POSITIVE] Your name is Ty. OK, perfect, [PII]. Thank you. Have a good one.
[AGENT][POSITIVE] Thank you for calling APL. You as well. Bye-bye.
[CUSTOMER][NEUTRAL] OK