AccountId: 011433970860
ContactId: f654f854-acf6-4088-bef9-bebc74ac0a5e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 191210 ms
Total Talk Time (AGENT): 87137 ms
Total Talk Time (CUSTOMER): 62733 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/17/f654f854-acf6-4088-bef9-bebc74ac0a5e_20250317T14:12_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] [PII], hi, this is [PII]. I'm calling from Cincinnati Allergy Associates. I'm calling to get some benefit information for a patient, please.
[AGENT][NEUTRAL] OK, I can assist with that [PII]. May I have your callback number please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, what is the policy number please?
[CUSTOMER][NEUTRAL] That is.
[CUSTOMER][NEUTRAL] 02465406 M as in Mike L as in Lima.
[CUSTOMER][NEUTRAL] 8.
[AGENT][POSITIVE] OK, I have that as 02465406ML8. Thank you.
[AGENT][NEUTRAL] Verify the patient's name and date of birth please.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth [PII].
[AGENT][POSITIVE] OK, thank you and you're calling for outpatient benefits so give me one moment I'll help you with that.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, this policy shows effective for Ms. [PII] as of [PII] shows that is active. Please note verification of benefits provided does not guarantee payment. The outpatient max for the calendar year is $5000.
[AGENT][NEUTRAL] Uh, would this be for an office setting or a facility, please?
[CUSTOMER][NEUTRAL] Office
[AGENT][NEUTRAL] OK, let me just check to see if she has any benefits for office setting. One moment.
[AGENT][NEUTRAL] OK, the plan does not cover for office visits or settings.
[CUSTOMER][NEUTRAL] What does it cover?
[AGENT][NEUTRAL] It covers things such as facilities, ER, urgent care.
[AGENT][NEUTRAL] Diagnostic testing facility hospital outpatient facility.
[CUSTOMER][NEUTRAL] Wonder if she knows that. I'll make sure she does. Is there a call reference number please, [PII]?
[AGENT][NEUTRAL] Uh, no, you can use my name. My last initials [PII] and today's date. Anything else I can help you with, [PII]?
[CUSTOMER][NEUTRAL] So is this like some kind of major medical plan?
[AGENT][NEUTRAL] No, this is her supplemental to her major medical.
[CUSTOMER][NEUTRAL] It's supplemental, but it doesn't cover providers or anything done in office.
[AGENT][POSITIVE] That is correct. That is correct, yes.
[CUSTOMER][NEUTRAL] Is that correct?
[CUSTOMER][NEUTRAL] It only covers facility charges.
[AGENT][NEUTRAL] Yes, in addition to like um ER visits, urgent care, but yes, it does not cover the office visit or any services or procedures inside.
[CUSTOMER][POSITIVE] I bet she didn't know that when she signed up for it. OK, thank you very much for your help.
[AGENT][POSITIVE] You're welcome, [PII] thanks for calling APL. Take care bye.