AccountId: 011433970860
ContactId: 035473a0-eb19-4538-8470-3ba6b9561f3f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 238850 ms
Total Talk Time (AGENT): 104845 ms
Total Talk Time (CUSTOMER): 83965 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/02/035473a0-eb19-4538-8470-3ba6b9561f3f_20250102T14:31_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Thank you. Good morning. My name is [PII]. I'm calling from the doctor's office. I need to check benefit and eligibility for specialist office visit, please, and procedures on an office setting.
[AGENT][POSITIVE] Yeah, I'd love to help you with that today.
[AGENT][NEUTRAL] And do you mind if I get the policy number for the patient?
[CUSTOMER][NEUTRAL] Yes, it is 02273058 ML 8.
[AGENT][NEUTRAL] Thank you, Ms. [PII]. And while I'm getting that policy pulled up, do you mind if I also get a good call back number from you as well today?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect, thank you. And I'm sorry, that policy is still loading.
[CUSTOMER][NEUTRAL] What what is your name?
[AGENT][NEUTRAL] Oh, my name is [PII]
[AGENT][NEUTRAL] And Ms. [PII], can I have your patient's first and last name and date of birth when you're ready?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yes, [PII] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Perfect. Your patient is current and active. She has an effective date of [PII] and.
[AGENT][NEUTRAL] Yeah, let me take a look at her benefits for you. One second.
[AGENT][NEUTRAL] All right. It looks like your patient has an outpatient benefit of $1000 per calendar day, and I do see that she has treatment in an office on her policy. I do want to let you know that anything I give you over the phone is just a verification of coverage, though never guarantee a payment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, can I, can you help me with another one?
[AGENT][POSITIVE] Yeah, another person absolutely give me one second.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] So I know for the for the first one office visit is not covered, right? Only for procedures on in office setting.
[AGENT][NEUTRAL] Yeah, just treatment done in an office setting.
[CUSTOMER][POSITIVE] And she has $1000 per calendar day perfect.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] And then Miss [PII], was there anything else I could help you with?
[CUSTOMER][NEUTRAL] Oh, the other one, remember?
[AGENT][POSITIVE] Oh, OK, perfect. I'm ready when you are then, my friend.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] 01
[CUSTOMER][NEUTRAL] 611667 ML 8.
[AGENT][NEUTRAL] And that patient's first and last name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII] uh who work 524 71.
[AGENT][NEUTRAL] Thank you very much. And this patient is current and active as well with us, with an effective date of October, I'm sorry, [PII].
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] It looks like this patient has an outpatient calendar year maximum of $1500 and they also have treatment in an office setting on their policy.
[CUSTOMER][POSITIVE] Perfect thank you so much [PII] have a new year.
[AGENT][POSITIVE] Thank you. Happy new year, Miss [PII]. Thanks for calling APL. You have a great day.
[CUSTOMER][POSITIVE] Happy New Year.
[CUSTOMER][POSITIVE] You too, happy new year bye bye.
[AGENT][POSITIVE] Thanks bye bye.