AccountId: 011433970860
ContactId: f8cb63c8-f0f4-4283-b204-2d5c54d114af
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 201979 ms
Total Talk Time (AGENT): 114164 ms
Total Talk Time (CUSTOMER): 75712 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/07/f8cb63c8-f0f4-4283-b204-2d5c54d114af_20250107T20:25_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, so I'm calling from South Florida Perinatal Medicine. My name is [PII]. I have a patient who came with this, uh, gap insurance. I wanted to know because she's currently pregnant if you guys offer like maternity coverage.
[AGENT][NEUTRAL] OK. Sure. I can assist you with that information with maternity coverage. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] I have.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] I just have, oh wait, is it? I have a benefit certification number is that what I would be giving you? OK, it's 016.
[AGENT][NEUTRAL] Yeah, mhm, yeah.
[CUSTOMER][NEUTRAL] 263-72.
[CUSTOMER][NEUTRAL] M as in mom.
[CUSTOMER][NEUTRAL] L as in Larry, the number 8.
[AGENT][NEUTRAL] OK, thank you. And may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yes, [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK. Thank you. All right, Ms. [PII], and let me go ahead and give you the benefits, and this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. We have an effective date of [PII]. It is active at the moment and this is one of our secondary supplemental plan to the major medical.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] that.
[AGENT][NEUTRAL] Um, with this plan, we help with the deductibles, co-payment and co-insurance from the major medical. Um, for the delivery, we have an inpatient maximum of 7000 per covered person per calendar year.
[AGENT][NEUTRAL] For the outpatient, we also have an additional 7000 per cover person per calendar year, and this includes any office treatments, lab work, and any ER visits if she needs to go to the ER. Um, the only thing that we do not cover is the office visits, the co-payment for the office visit.
[AGENT][NEUTRAL] But we do cover for any procedures done in the office.
[CUSTOMER][NEUTRAL] OK, so if she was doing imaging in office setting that would be considered uh not covered from what I'm understanding.
[AGENT][NEUTRAL] No, yes, we do cover office treatment or office procedures. So any procedures done in the office will be considered. The only thing we do not cover is the co-payment for the visit itself like a 99214, 99211, like an office visit.
[AGENT][NEUTRAL] Consultation.
[CUSTOMER][NEUTRAL] Oh, I see, I see, I see. Oh, OK, OK, OK, yeah, so you guys will be able to pick up this. OK, perfect. Can I have a reference number to the call?
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] We don't have reference numbers, but you can use my name in today's date if you will. Do you need the spelling of my name or any other information?
[CUSTOMER][NEUTRAL] Is it [PII]?
[AGENT][NEUTRAL] Yes. Mhm.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] And and what did you say you're um OK and today's date?
[AGENT][NEUTRAL] Last initial [PII]
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, mhm.
[CUSTOMER][POSITIVE] OK perfect OK thank you so much for your help.
[AGENT][POSITIVE] You're welcome. Is there anything else I may help you with today?
[CUSTOMER][POSITIVE] No, that was it thank you so much.
[AGENT][NEUTRAL] Oh
[AGENT][POSITIVE] Thank you for calling APR. Have a good day. Bye-bye, Ms. [PII].