AccountId: 011433970860
ContactId: f5d75b7c-a0b2-4d92-8f28-83978e0f71f0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 296140 ms
Total Talk Time (AGENT): 126760 ms
Total Talk Time (CUSTOMER): 124089 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/f5d75b7c-a0b2-4d92-8f28-83978e0f71f0_20250213T20:49_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from the provider's office just to verify members' benefits.
[CUSTOMER][NEUTRAL] Uh, I don't think you guys use CPT codes. I'm not sure how to go, um.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Hope we can guide me.
[AGENT][NEUTRAL] OK, um,
[AGENT][POSITIVE] Yes ma'am, I can most definitely guide you on benefits uh Miss [PII], what is your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, thank you. And then what's the patient's name?
[CUSTOMER][NEUTRAL] First name is uh spelled [PII], and last name is spelled [PII]
[AGENT][NEUTRAL] OK, and what Tria's date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the policy number, please?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] It is
[CUSTOMER][NEUTRAL] 02595965
[CUSTOMER][NEUTRAL] M as in Mary, L as in Lima, and then the number 8?
[AGENT][POSITIVE] OK, thank you so much and let me pull in that policy for us.
[AGENT][NEUTRAL] OK, I do show that Terria does have an active policy. The effective date of the policy is [PII].
[AGENT][NEUTRAL] And this is just to verify coverage. It's not a guarantee of payment. This is a supplemental insurance policy. It's a gap insurance and it helps with deductible, co-pay, and co-insurance.
[AGENT][NEUTRAL] So the insured.
[CUSTOMER][POSITIVE] Perfect, yes she was.
[AGENT][NEUTRAL] They go in the hospital um for 18 hours or more. They have an inpatient benefit of $5000 but then they also have an outpatient calendar year that amount of $5000.
[CUSTOMER][POSITIVE] Oh, that's beautiful, OK.
[AGENT][POSITIVE] Yes ma'am, and it does help with deductible, co-pay or co-insurance for accident or sickness.
[CUSTOMER][NEUTRAL] Got it regardless of the.
[CUSTOMER][NEUTRAL] OK. Uh, so does it, you said for accidents or what?
[AGENT][NEUTRAL] It's for accident or sickness. So if they have to go so if they have to go outpatient to a facility for accident or sickness or inpatient for accident or sickness.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] OK. Does this also mm include maternity to cover their deductibles and out of pockets towards maternity coverage?
[AGENT][NEUTRAL] Yes, maternity considered sickness.
[CUSTOMER][NEUTRAL] Oh, OK then.
[CUSTOMER][NEUTRAL] OK, got you. OK, that makes.
[AGENT][NEUTRAL] I know, right?
[CUSTOMER][NEUTRAL] I was like, uh, but I understand, I understand it.
[AGENT][NEUTRAL] Yeah,
[AGENT][POSITIVE] I, when I started working and I heard that, I was like that explains everything.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][POSITIVE] Wow, I, I really do love that. I was like, oh, but you know what, they're not lying.
[CUSTOMER][NEUTRAL] You've had some couple of babies, you're like, yeah, this is a lot.
[AGENT][NEUTRAL] Right
[CUSTOMER][NEUTRAL] OK, perfect. So inpatient of 5000, outpatient of 5000. Is there anything else that I need to know about her benefits? Uh.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um, there, there's no authorization I'm assuming because it's just, it's a supplement.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Right, uh, there is no authorization because we're not the primary, yeah, you're correct.
[CUSTOMER][POSITIVE] Perfect. Awesome. OK, I think that's all I need to know. This is not a bad plan at all. All right. And if I can get a reference number for this call?
[AGENT][NEUTRAL] No.
[AGENT][POSITIVE] Yes ma'am you can use for.
[AGENT][NEUTRAL] And today's date.
[CUSTOMER][NEUTRAL] Oh, you went in and out, [PII], hello?
[AGENT][NEUTRAL] You can use my name [PII] and today's date.
[CUSTOMER][POSITIVE] Perfect what's the initial and last name for my notes?
[AGENT][NEUTRAL] It's A
[CUSTOMER][NEUTRAL] Girl, when you're done
[CUSTOMER][POSITIVE] Awesome thank you so much, [PII]. It was a pleasure speaking to you.
[AGENT][NEUTRAL] And Miss [PII], what's the name of the facility you're calling from? It's you.
[CUSTOMER][NEUTRAL] Yes, Boca, uh um uh boca babes, OBGYN.
[AGENT][POSITIVE] OK dokey thank you I appreciate [PII] you have a a blessed day and thanks for calling APL.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] You too thank you bye bye.
[AGENT][NEUTRAL] Mm