AccountId: 011433970860
ContactId: 03cce68a-e01c-4551-ae66-34ae5ece9782
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 151580 ms
Total Talk Time (AGENT): 67166 ms
Total Talk Time (CUSTOMER): 50218 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=2.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/22/03cce68a-e01c-4551-ae66-34ae5ece9782_20250122T17:04_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good, good afternoon. My name is [PII]. I'm calling because I want to check the benefits of a member.
[AGENT][POSITIVE] Alright, I'm happy to check on benefits. What is the policy number?
[CUSTOMER][NEUTRAL] OK, that would be.
[CUSTOMER][NEUTRAL] 02263029.
[AGENT][POSITIVE] All right, thank you so much. Let me just pull this up here.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And if I can get patient's name and date of birth, please?
[CUSTOMER][POSITIVE] Of course, that would be nice. [PII].
[CUSTOMER][NEUTRAL] They think
[AGENT][NEUTRAL] Thank you and just date of birth.
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][POSITIVE] Thank you so much. So the patient plan is active. The effective date is [PII]. We are the secondary insurance, so this covers deductible, co-pay, and co-insurance. The primary does not.
[AGENT][NEUTRAL] Looks like the plan has an outpatient benefit max per occurrence, which is $500.
[CUSTOMER][NEUTRAL] It has a maximum um coverage of $500.
[AGENT][NEUTRAL] Correct, for outpatient and that's per occurrence, so meaning being seen for the same thing.
[CUSTOMER][NEUTRAL] And for inpatient?
[AGENT][NEUTRAL] Um, inpatient is also per occurrence, and it looks like the benefit max for that is 5000.
[CUSTOMER][NEUTRAL] 5000.
[CUSTOMER][NEUTRAL] OK, so it would cover the copays, um, the, the doctor will be out of pocket then.
[CUSTOMER][NEUTRAL] For uh for up to 5000 for inpatient.
[AGENT][POSITIVE] Mm. Mhm. Correct, yeah.
[CUSTOMER][POSITIVE] OK perfect thank you and you said your name was [PII]?
[AGENT][NEUTRAL] Yeah, that is correct. That is the call reference with my last initial to my name, which is [PII].
[CUSTOMER][POSITIVE] OK, perfect. Thank you so much.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][NEUTRAL] Bye-bye.