AccountId: 011433970860
ContactId: f27b1f48-43e0-4a47-b30d-aa99e700fe97
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 169539 ms
Total Talk Time (AGENT): 82900 ms
Total Talk Time (CUSTOMER): 69661 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/02/f27b1f48-43e0-4a47-b30d-aa99e700fe97_20250102T14:02_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] Um, hi, [PII]. My name is [PII], and I have individual coverage. And I can give you the payer, I mean, uh, the group ID number.
[AGENT][NEUTRAL] Um, do you have your card with you?
[CUSTOMER][NEUTRAL] I do.
[AGENT][NEUTRAL] Do you see, um, it should say in hospital or outpatient policy cert number?
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] May I have that, that's your policy number.
[CUSTOMER][NEUTRAL] OK, 024.
[CUSTOMER][NEUTRAL] 96763 ML 8
[AGENT][POSITIVE] Thank you. Hold on one moment.
[AGENT][NEUTRAL] OK, I have you pulled up here and [PII], can you verify your date of birth, your mailing and email address on file?
[CUSTOMER][NEUTRAL] Yes, date of birth is [PII] and you said my email address should be [PII].
[AGENT][NEUTRAL] And then just your mailing address.
[CUSTOMER][NEUTRAL] Uh [PII].
[AGENT][POSITIVE] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. Oh, and one more thing, what's a good contact number just in case we're disconnected I can call you back.
[CUSTOMER][NEUTRAL] Yes, ma'am. [PII].
[AGENT][POSITIVE] Thank you for that. And how may I help you today, [PII]?
[CUSTOMER][NEUTRAL] Alright, so basically what happened is, is I had some blood work and it was on outpatient, uh, but it wasn't in the hospital. It was actually with my doctor's office. Now I submit that as a claim. Would that qualify?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let me take a look at your benefits. If you have the um
[AGENT][NEUTRAL] If you have physician office coverage or if you have the um office treatment rider, then yes, that treatment in the office should be covered, but hold on one second, it's coming up now.
[CUSTOMER][NEUTRAL] Yeah, I.
[CUSTOMER][NEUTRAL] Thank you for verifying that because I did submit two claims. I didn't know if they were going to be covered or not.
[AGENT][NEUTRAL] You're very welcome. I'm just waiting for the benefits to pop here. Hold on one moment.
[AGENT][NEUTRAL] And all the information provided is a verification of benefits, not a guarantee of payment. So, for your policy, you don't have the, your secondary policy. You don't have the office treatment rider. Um, it would have only covered it if it was in a hospital outpatient facility or MRI facility.
[CUSTOMER][POSITIVE] Got it, got it. OK, ma'am, that's what I need to know. Thank you so much.
[AGENT][POSITIVE] You're welcome. Well, was there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, ma'am. Thank you though.
[AGENT][POSITIVE] All right, well, thanks for calling APL and [PII].
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][NEUTRAL] Bye-bye.