AccountId: 011433970860
ContactId: e832f6ee-f979-4600-81c6-f1bb0da2c470
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 208800 ms
Total Talk Time (AGENT): 93521 ms
Total Talk Time (CUSTOMER): 91589 ms
Interruptions: 1
Overall Sentiment: AGENT=1.7, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/29/e832f6ee-f979-4600-81c6-f1bb0da2c470_20250129T14:21_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], good morning. My name is [PII]. I'm calling from West kind of Baptist Diagnostic in regards to a patient just wanting to verify their, um, their gap insurance that they have here.
[AGENT][NEUTRAL] Um, for benefits or like to the eligibility or both?
[CUSTOMER][NEUTRAL] Um, both.
[AGENT][POSITIVE] Both, OK. Well, I'll be more than happy to help you with the benefits and the eligibility and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes. It's gonna be [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the policy number?
[CUSTOMER][NEUTRAL] Yeah, the policy number is
[CUSTOMER][NEUTRAL] 02175463ML8
[AGENT][POSITIVE] 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] Yes, his first name is [PII], um, last name [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm. And then just the date of birth.
[CUSTOMER][NEUTRAL] [PII] OK, the date of birth is, OK, give me one moment.
[CUSTOMER][NEUTRAL] A [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].
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] Um, I wanted to see if he was, he's already covered then through his cal through the gap. So he's getting a lumbar spine X-ray. I have a CB uh, the CBT code here.
[CUSTOMER][NEUTRAL] OK, OK, let me check. OK.
[AGENT][NEUTRAL] Wait, wait. So you just want to know if diagnostic testing is covered on the policy?
[CUSTOMER][NEUTRAL] Yeah, it's covered on the policy, right?
[AGENT][NEUTRAL] OK. Hold on one second.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] There's different, no.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Let me look here because that one doesn't show it clearly. Hold on one second.
[CUSTOMER][POSITIVE] No, no, no problem.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] So for outpatient, the benefit is up to $500 per calendar day. I'm just checking the um documents to make sure diagnostic testing is on here because I can't see it on the screen.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] Perfect. So he has already a medical insurance that he would have to pay 50 for, so that means that it'll be covered then.
[AGENT][NEUTRAL] Well, not necessarily. Our secondary policies have its own benefits, so it, it, we work with primary, yeah, but they have their own benefits. Hold on one second. But yeah, I just thought, so diagnostic testing in a hospital outpatient facility or MRI facility, um, up to that $500 per calendar day.
[CUSTOMER][NEUTRAL] Oh, I see.
[CUSTOMER][NEUTRAL] I see.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect. Thank you so much um for that information. I'm going to, uh, all I need is a reference number and I'm good.
[AGENT][NEUTRAL] OK. Um, so there's no call reference number, but you can use my name and today's date. And again, that's [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK perfect thank you so much I really appreciate it.
[AGENT][POSITIVE] You're welcome, [PII]. Thanks for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][POSITIVE] Thank you, bye bye