AccountId: 011433970860
ContactId: 0adfb3cc-1c9e-4110-ac06-4a3c59f69b86
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 120589 ms
Total Talk Time (AGENT): 65698 ms
Total Talk Time (CUSTOMER): 34610 ms
Interruptions: 0
Overall Sentiment: AGENT=2.2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/0adfb3cc-1c9e-4110-ac06-4a3c59f69b86_20250609T18:43_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Hi, I'm just calling to verify eligibility for.
[CUSTOMER][NEUTRAL] Uh, one of your members, this is AdventHealth Gastro and Celebration calling.
[AGENT][POSITIVE] Yes, ma'am. I can assist you with benefits. And first, could I get your name again and a callback number?
[CUSTOMER][NEUTRAL] Yes, my name is [PII]. The number is [PII].
[CUSTOMER][NEUTRAL] [PII]. I'm sorry.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] The policy number is 02603763.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Her name is [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Thank you and just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII]. The policy is still active. And is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] An office visit?
[AGENT][NEUTRAL] OK. Actually, office visits are not covered under the policy. Um office treatments are covered and that, that's, that's for the charges that goes towards the coinsurance and the deductible, but the co-pay for the office visit is not covered. And um the co-insurance and deductible, that's covered up to 4000 per calendar year after the primary insurance process is the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK perfect that was all I needed to know thank you.
[AGENT][POSITIVE] OK. Well, since there isn't anything else I can assist you with, [PII], I thank you for calling APL. Have a great day. Mm bye.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Um thank you.