AccountId: 011433970860
ContactId: 03682f13-12bf-4b00-b9d7-90f20839c406
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 271609 ms
Total Talk Time (AGENT): 114232 ms
Total Talk Time (CUSTOMER): 73555 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/13/03682f13-12bf-4b00-b9d7-90f20839c406_20250113T22:06_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. Last initial [PII] I'm calling from Gulf South Eye Associates. I was calling for benefits and eligibility. A patient, uh, provided APL as a secondary insurance, and I'm just not familiar with the plan, so I was calling for, uh, benefits and eligibility.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, Miss [PII], um, I can help you with benefits and eligibility. Can you please give me your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Mhm, sure it's [PII].
[AGENT][NEUTRAL] OK, thank you and then what is the patient's name?
[CUSTOMER][NEUTRAL] The patient's name is [PII].
[AGENT][NEUTRAL] OK, and what's [PII]'s date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then what is her policy number?
[CUSTOMER][NEUTRAL] OK, let's see that would be 0 I'm sorry, I'm looking at the wrong card. They on it.
[CUSTOMER][NEUTRAL] Uh, let's see, that would be 02578795.
[AGENT][NEUTRAL] That's OK.
[AGENT][NEUTRAL] Oh OK let me pull her in real quick.
[AGENT][NEUTRAL] OK, I do show that [PII] does have an active policy with us and her effective date is [PII].
[AGENT][NEUTRAL] And this is just to verify her coverage it's not a guarantee of payment.
[AGENT][NEUTRAL] She has, uh, this is a medical gap plan that helps with and deductible co-pay and co-insurance.
[AGENT][NEUTRAL] She has an inpatient benefit amount of $5000 per calendar year and then she also has an outpatient benefit amount.
[AGENT][NEUTRAL] Of let me look for you real quick.
[CUSTOMER][NEUTRAL] OK, what does this cover like a specialist office visit?
[AGENT][NEUTRAL] Let me go ahead and pull her policy in to to to verify that for sure if it does cover, yes ma'am, but her outpatient um benefit amount is $4000 per calendar year. Let me go ahead and pull in the policy and read if she has specialist visits on her policy.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] It's gonna be a moment because it's a big policy and it's gonna take a little bit for it to download.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][POSITIVE] Oh, thank you.
[AGENT][NEUTRAL] You're welcome. I just wanna be sure.
[AGENT][NEUTRAL] OK, let's see. Her policy covers physician office visits for accident or sickness.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So if it's for accident or sickness, it can be covered in the physician's office.
[CUSTOMER][NEUTRAL] OK, alright, good, that's, that's what I need to know is there a reference number for the phone call please?
[AGENT][NEUTRAL] Yes, ma'am. You can use my name, [PII], and today's date.
[CUSTOMER][POSITIVE] OK great thank you so much I appreciate it.
[AGENT][POSITIVE] You're very welcome, [PII]. I hope you have a great rest of your night and thanks for calling APL.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] Thank you, thank you, bye bye.
[AGENT][POSITIVE] You're welcome.