AccountId: 011433970860
ContactId: 0c134e16-d07f-420f-9f84-688a654bb338
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 224699 ms
Total Talk Time (AGENT): 106364 ms
Total Talk Time (CUSTOMER): 96840 ms
Interruptions: 4
Overall Sentiment: AGENT=2.8, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/0c134e16-d07f-420f-9f84-688a654bb338_20250306T18:20_UTC.wav
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[AGENT][POSITIVE] Good. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Hi, I need to verify the plans, um, effective date and then get specialty office benefits.
[AGENT][NEUTRAL] OK, so you're needing eligibility and benefit information, is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And the member's policy number, please, [PII]?
[CUSTOMER][NEUTRAL] 01687790
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] back up the works.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] He's got a birth in the bathroom he's good like that.
[CUSTOMER][NEUTRAL] He's just a he's a grown man he is but he was just that.
[CUSTOMER][NEUTRAL] So he went out delivery was down and I said.
[CUSTOMER][NEGATIVE] Come on, I put it up here.
[CUSTOMER][NEUTRAL] uh.
[AGENT][NEUTRAL] OK, and [PII], any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name, please, and their date of birth?
[CUSTOMER][NEUTRAL] I said we had.
[CUSTOMER][NEUTRAL] it just looked at.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] I think I had to take a video.
[CUSTOMER][NEUTRAL] the man
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, so I do show that he is the subscriber on this limited benefit plan and this policy is active actually with an effective date of [PII].
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] red in there.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And on this limited benefit plan, he has an outpatient sickness rider for um an office visit. The maximum benefit per visit is $75 and a maximum of 5 visits per calendar year.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] How many has he used?
[AGENT][NEUTRAL] I can check that for you, just a moment.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] As of now, he has used 2.
[CUSTOMER][POSITIVE] OK all right thank you so much.
[AGENT][POSITIVE] Well, you are certainly welcome. And then [PII], oh, I'm so sorry, go ahead in a minute.
[CUSTOMER][NEUTRAL] And does this
[CUSTOMER][NEUTRAL] No, it's OK. Does this plan have uh sur surgical benefits?
[AGENT][NEUTRAL] It does. The max benefit would be 1, the surgical schedule benefit is $1000 with an anesthesia benefit with that would be 25% of the surgical benefit amount.
[CUSTOMER][POSITIVE] OK all right perfect thank you.
[AGENT][NEUTRAL] Well, you are certainly welcome and then one last thing [PII], should you all end up filing a claim with us for this number once the claim has been processed, we do have a portal that you should be able to check claim status in and that portal website is located at [PII].
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK perfect thank you so much.
[AGENT][POSITIVE] Well, you are certainly very welcome. So again, is there anything else I can help you with?
[CUSTOMER][POSITIVE] That's it thank you so much.
[AGENT][POSITIVE] Well, you're certainly welcome. And again, thank you for calling APL. Have a wonderful afternoon.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thank you