AccountId: 011433970860
ContactId: 050af987-1eba-4402-ab78-154e11989695
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 273299 ms
Total Talk Time (AGENT): 77707 ms
Total Talk Time (CUSTOMER): 62086 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/050af987-1eba-4402-ab78-154e11989695_20250121T15:47_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I just need to verify the patient's eligibility, please.
[AGENT][NEUTRAL] I can help you. What's your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], what's the policy number?
[CUSTOMER][NEUTRAL] It's uh 0203568 M as in Mary, L as in Larry and 8.
[AGENT][NEUTRAL] OK, what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. Give me one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And if you can verify the patient's name and date of birth for me?
[CUSTOMER][NEUTRAL] It is [PII] and it's [PII], date of birth.
[AGENT][NEUTRAL] Uh, [PII]. OK, I think I missed a digit. I have 0203568.
[CUSTOMER][NEUTRAL] Yes, and M as in Mary, L as in Larry 8. I don't have the card, so that's what she was given to us.
[AGENT][NEUTRAL] You want
[AGENT][NEUTRAL] Yeah, so it's missing one number spell the patient's uh first and last name for me.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII] and then [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Spell the first name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And spell the last name?
[CUSTOMER][NEUTRAL] [PII], and then she, I guess she has a second last name [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Is this a claim as a result of an accident or no?
[CUSTOMER][NEUTRAL] No, I'm calling from the specialist office. I need to know if this secondary covers the primary insurance copay deductible or if this is only for hospital coverage.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so you now need eligibility and then office visit benefit, is that correct?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] OK, so the policy number is 020.
[AGENT][NEUTRAL] 352-68.
[AGENT][NEUTRAL] And I'm showing an effective date. One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Of [PII]. The policy is active at this time.
[CUSTOMER][NEUTRAL] In
[AGENT][NEUTRAL] The office visit co-pay.
[AGENT][NEUTRAL] It's not covered under this policy?
[AGENT][NEUTRAL] Uh, there is a treatment rider. So if there's treatment during the course of that office visit, covered items can be considered under the outpatient benefit.
[AGENT][NEUTRAL] Did you want the treatment rider benefit or is it just for the physician's fee?
[CUSTOMER][NEUTRAL] No, it's OK. It's no, it's only physician fee, so if it doesn't cover, then that's what I wanted to know. Alright, perfect.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. All right. Anything else?
[CUSTOMER][POSITIVE] Nope, that'll be all. You answered my question.
[AGENT][POSITIVE] All right. All right, [PII]. Thank you for calling APL. Have a good day.
[CUSTOMER][POSITIVE] Thank you you too bye.