AccountId: 011433970860
ContactId: 0a77d7a9-6eb7-4021-84a7-7b7bf038bac7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 391910 ms
Total Talk Time (AGENT): 126589 ms
Total Talk Time (CUSTOMER): 213680 ms
Interruptions: 4
Overall Sentiment: AGENT=0.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/0a77d7a9-6eb7-4021-84a7-7b7bf038bac7_20250219T15:51_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling. This is.
[CUSTOMER][NEUTRAL] Hello? Hello?
[AGENT][POSITIVE] Yes, thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, how are you? I'm calling because I wanted, I wanted to, um, verify uh if you guys are still a policy is still active.
[AGENT][NEUTRAL] OK, I can verify eligibility for you and your name is?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh, spell your name for me.
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] Spell your name for me, please.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Yes we do.
[AGENT][NEUTRAL] OK, and what is that policy number, please?
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] What is the policy number?
[CUSTOMER][NEGATIVE] Oh no sorry
[CUSTOMER][NEUTRAL] Yes, the policy number is.
[CUSTOMER][NEUTRAL] Let me find it.
[CUSTOMER][NEUTRAL] Then, um, just stop calling him.
[CUSTOMER][NEUTRAL] Yep
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] One second, I'm trying to find it.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] OK, it's 0659502.
[AGENT][NEUTRAL] OK. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] [PII], date of birth, [PII].
[AGENT][NEUTRAL] Uh, do not show that patient. Give me that policy number again. You said 659502?
[CUSTOMER][NEUTRAL] No 060659502.
[AGENT][NEUTRAL] OK, and I don't show that patient under this policy.
[CUSTOMER][NEUTRAL] Yeah um.
[CUSTOMER][NEUTRAL] You don't see the patient under that that policy?
[AGENT][NEUTRAL] Correct. And what's the patient's name again? I can look to see if they have it.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And uh spell the last name for me.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. And that date of birth again?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, one moment, let me see there I search by the name. Give me one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I've been number of the card. I mean, uh, which card that number.
[CUSTOMER][NEUTRAL] take that to my face.
[AGENT][NEUTRAL] OK. Uh, when you're ready, I can give you the correct policy number.
[CUSTOMER][NEUTRAL] OK, go ahead.
[AGENT][NEUTRAL] OK, it's 1659502.
[CUSTOMER][POSITIVE] OK, I think that that does that policy number ever like change often because that was the same like the um like last time they had changed it as well they couldn't find it, but OK, thank you so much for that new policy number.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] OK, and what was the date of service and amount of the charge? Oh, What are you calling for eligibility.
[CUSTOMER][NEUTRAL] Give me 1 2nd, give me 1 2nd.
[AGENT][POSITIVE] Bless it.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] OK, yes, ma'am. And uh [PII], you say you were calling for eligibility, correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I'm showing her effective date is [PII] and I'm showing the policy is active.
[CUSTOMER][NEUTRAL] OK, can I have your first name?
[AGENT][NEUTRAL] Sure, it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Uh, thanks.
[CUSTOMER][NEUTRAL] Uh let me see.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Since when has the policy been effective?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] But I.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And how um does the policy, how much does it cover up to how many visits?
[AGENT][NEUTRAL] What benefits are you needing?
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] PCP.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] OK, um, not a guarantee of payment, just the verification of coverage for an office visit, general office visit, the max payable is $25 per visit and they have a total of 4 visits per year.
[CUSTOMER][NEUTRAL] Hi Doctor [PII].
[CUSTOMER][NEGATIVE] I don't want
[CUSTOMER][NEUTRAL] on that.
[CUSTOMER][NEUTRAL] OK. OK. OK, and how many people are under this policy, do you know?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, just her and a dependent.
[CUSTOMER][NEUTRAL] So the total visits per calendar year will be 84 visits each.
[AGENT][NEUTRAL] 4 per person, a total for family.
[CUSTOMER][NEUTRAL] Yes, you call them, tell them you wanna switch your primary care doctor to correct, and then you ask them and does this cover the copay the patient has? He has, she has a $10 copay.
[AGENT][NEUTRAL] Yes ma'am. Like I said, for an office visit, it pays up to $25 per visit, a total of 4 visits per year.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][POSITIVE] both of you 101. Thank you.
[CUSTOMER][POSITIVE] Perfect, can I have a reference number?
[AGENT][NEUTRAL] Uh, we don't give reference numbers. If you like, you may use my name in today's date.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Perfect thank you so much have a great day.
[AGENT][POSITIVE] Oh, you too. Thank you for calling APL. Bye.