AccountId: 011433970860
ContactId: f371c281-34e8-4fe6-a5b1-d50a34e59749
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 154779 ms
Total Talk Time (AGENT): 76892 ms
Total Talk Time (CUSTOMER): 68340 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/f371c281-34e8-4fe6-a5b1-d50a34e59749_20250124T16:42_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] Good morning, [PII]. My name is [PII]. I'm calling from Mont Sinai Medical Center.
[CUSTOMER][NEUTRAL] And I'm calling um regarding a patient that is here in the emergency room. however, he is here as an outpatient to do a specific exam and I'm calling to verify benefits to see if um APL cover um for that exam.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, well, I'll be more than happy to assist you with the coverage for the exam. Um, so it's when you say exam, so it's like diagnostic testing or it's like a procedure? OK.
[CUSTOMER][POSITIVE] Correct, it's a CT scan, yeah.
[AGENT][NEUTRAL] OK. And may I have a good contact number in case we're disconnected and then the policy number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you for that. [PII], may I have the member's policy number?
[CUSTOMER][NEUTRAL] 02503264
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] First name is [PII]. Last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So I am showing that the policy is active. It's been effective since [PII]. And for outpatient, the policy would pay up to
[AGENT][NEUTRAL] Hold on one moment. $1500 per person per calendar year?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That does include um diagnostic testing performed in a hospital outpatient facility, MRI facility, or physician office.
[CUSTOMER][NEUTRAL] OK, calendar.
[CUSTOMER][NEUTRAL] OK, we are an outpatient services facility.
[AGENT][NEUTRAL] OK. So that would be up to that 1500 calendar year.
[CUSTOMER][NEUTRAL] Then $500.
[CUSTOMER][NEUTRAL] Yeah, OK, not a problem, I'll go ahead and put that on the notes um do you have a conference uh a reference number for this call?
[AGENT][NEUTRAL] So there's no um call reference number, but you can use my name, which is [PII], and then today's date.
[CUSTOMER][POSITIVE] OK, not a problem thank you so much for your help you have a good day, OK?
[AGENT][POSITIVE] You're welcome, [PII]. You also, and thanks for calling APL.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][POSITIVE] You're welcome. Bye bye.