AccountId: 011433970860
ContactId: e709eb6f-d39e-49f4-99ef-cd39a3d227c8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 355260 ms
Total Talk Time (AGENT): 117549 ms
Total Talk Time (CUSTOMER): 97109 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/12/e709eb6f-d39e-49f4-99ef-cd39a3d227c8_20250612T15:24_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling IPL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Hi, [PII]. I'm trying to verify benefits on the patient.
[AGENT][NEUTRAL] OK, I can help you with that. What was your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] And do you have a callback number I can get?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII]. And do you have the policy number?
[CUSTOMER][NEUTRAL] It's 02506280.
[AGENT][NEUTRAL] Thank you [PII], hold on one moment please.
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And her date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you, [PII], and you were just needing benefits?
[CUSTOMER][NEUTRAL] Yeah it's for hearing aid and hearing evaluation services.
[AGENT][NEUTRAL] OK, when is she coming in?
[CUSTOMER][NEUTRAL] He's coming in on the [PII] uh tomorrow.
[AGENT][NEUTRAL] Tomorrow, OK.
[AGENT][NEUTRAL] The effective date was [PII].
[AGENT][NEUTRAL] Any benefits given over the phone is not a guarantee of payment?
[AGENT][NEUTRAL] This policy does coordinate with the primary insurance, whatever the primary applies to their deductible copay or co-insurance.
[AGENT][NEUTRAL] And you said, is it in the doctor's office, outpatient or?
[CUSTOMER][NEUTRAL] Yeah, it's a specialist office.
[CUSTOMER][NEUTRAL] So you're the thing this one covers.
[CUSTOMER][NEUTRAL] The primary deductible?
[AGENT][NEUTRAL] Deductible copay or co-insurance?
[CUSTOMER][NEUTRAL] I'm sorry, say that again you're, you cut out.
[AGENT][NEUTRAL] Deductible, co-pay, or co-insurance?
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Hold on just a moment, let me see if office visit is covered, OK?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK. It's for a hearing test.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It doesn't cover the actual office visit, but it does cover uh services done in a doctor's office.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And any benefits given over the phone is not a guarantee of payment. Let me see how much we pay on that. Hold on one moment.
[AGENT][NEUTRAL] OK, we'll pay up to $7500.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] For the
[CUSTOMER][NEUTRAL] For the office visit?
[AGENT][NEUTRAL] For the hearing test.
[CUSTOMER][NEUTRAL] Oh, you know what?
[CUSTOMER][NEUTRAL] Hearing t.
[AGENT][NEUTRAL] Of
[CUSTOMER][NEUTRAL] You know what? I just realized she's actually, she's actually coming in for some dizziness testing. So, I, she's had, she's coming in for something else besides that.
[CUSTOMER][NEUTRAL] Um, it's, it would be.
[AGENT][NEUTRAL] It doesn't cover the actual office visit. It covers services done in the doctor's office.
[CUSTOMER][NEUTRAL] I don't know, do you
[CUSTOMER][NEUTRAL] OK, so this is gonna be some it's videos demography testing. I don't know if you can look at codes or not, probably not. I'm guessing.
[CUSTOMER][NEUTRAL] Um, but, but it is a specialist.
[CUSTOMER][NEUTRAL] I guess my, uh, would you know if it covers that if I gave you the codes?
[AGENT][NEUTRAL] What is the procedure code?
[CUSTOMER][NEUTRAL] 92584.
[AGENT][NEUTRAL] 92584.
[CUSTOMER][NEUTRAL] I've got several
[CUSTOMER][NEUTRAL] Yeah, and then 92,540.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] What was the first code again?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] 92584
[AGENT][NEUTRAL] Yes, that would be services in the doctor's office, so it would be covered.
[AGENT][NEUTRAL] The only thing that's not covered is the actual office visit like [PII].
[CUSTOMER][NEUTRAL] OK, so they'll cover the remaining amount after the primary.
[AGENT][NEUTRAL] Only if it applies to their deductible co-pay or co-insurance.
[CUSTOMER][NEUTRAL] Is that correct?
[CUSTOMER][POSITIVE] Right, OK. OK, perfect. Yeah, that, that helps me then.
[CUSTOMER][NEUTRAL] Um, OK, is there a reference number for the call or how do you?
[AGENT][NEUTRAL] We do not have reference numbers you can use my name and today's date.
[CUSTOMER][POSITIVE] OK, great. Thank you for your help. I appreciate it.
[AGENT][POSITIVE] Thank you, [PII], for calling APL. You have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.