AccountId: 011433970860
ContactId: eb07a062-f9a5-4aa0-b082-7b48a95ebcfe
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 236570 ms
Total Talk Time (AGENT): 105607 ms
Total Talk Time (CUSTOMER): 55238 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/12/eb07a062-f9a5-4aa0-b082-7b48a95ebcfe_20250612T19:38_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yes, I'm trying to verify benefits for a patient.
[AGENT][NEUTRAL] OK, I could check benefits for you. Uh, what was your name, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and then do you have that policy number?
[CUSTOMER][NEUTRAL] Yes, it is um 02024680 M like Michael, 7.
[AGENT][NEUTRAL] OK, and then, uh, what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you for verifying that. Uh, so this policy terminated [PII]. Uh, if you give me one moment though, I'll see if they have one that's active, it might just be a different policy number.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, they do have one that is currently active uh let me know when you're ready and I'll give you that updated policy number.
[CUSTOMER][NEUTRAL] Sure, one second. Let me take this one off.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK. What's the new policy number?
[AGENT][NEUTRAL] OK, that is 02.
[AGENT][NEUTRAL] 17.
[AGENT][NEUTRAL] 54.
[AGENT][NEUTRAL] 27
[CUSTOMER][NEUTRAL] So, 021-75427?
[AGENT][NEUTRAL] Correct, but this one just picked up where the other left off, uh, effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays, and we're waiting to look at, uh, inpatient or outpatient benefits for this member.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, outpatient office visit?
[AGENT][NEUTRAL] OK, of course, I will let you know verification of coverage is not a guarantee of payment for claims. Give me just a moment, I'm gonna get the policy pulled up and see if uh office visits are covered under this policy.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright, I appreciate your patience, thank you. uh, so office visits are not going to be covered under this policy.
[CUSTOMER][NEUTRAL] OK. So it will cover like diagnostic testing, like, like ultrasound, stress tests.
[AGENT][NEUTRAL] Not in an office setting. So office visits nor treatment received in offices or clinics are covered under this policy. It's going to be, uh, they do have diagnostic testing benefits, but that would be in an MRI facility or a hospital outpatient facility.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, perfect. And your name?
[AGENT][NEUTRAL] It's [PII] Was there anything else I could help you with?
[CUSTOMER][POSITIVE] No, that's all. Thank you, [PII]. Have a good day.
[AGENT][POSITIVE] Alright, yeah, thanks for calling APL you too bye bye.
[CUSTOMER][NEUTRAL] Mm.