AccountId: 011433970860
ContactId: 0dfcf9fd-d9be-42a7-8fa2-9918f28450c3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 202860 ms
Total Talk Time (AGENT): 111430 ms
Total Talk Time (CUSTOMER): 75163 ms
Interruptions: 3
Overall Sentiment: AGENT=0.6, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/0dfcf9fd-d9be-42a7-8fa2-9918f28450c3_20250408T21:35_UTC.wav
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[AGENT][POSITIVE] Good Afternoon. Thank you for calling APL. This is Ph[PII]How may I assist you?
[CUSTOMER][NEUTRAL] 3
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh, yes, so I'm calling from a specialist office. I wanted to check the eligibility and benefits for a patient.
[AGENT][NEUTRAL] OK, sure, I can assist you with the eligibility and benefits, and may I have your name?
[CUSTOMER][NEUTRAL] I get that too.
[CUSTOMER][NEUTRAL] Ta[PII]?
[AGENT][NEUTRAL] And may I have a callback number just in case we get disconnected Miss To[PII].
[CUSTOMER][NEUTRAL] Do we have anything for you.
[CUSTOMER][NEUTRAL] 95[PII]t is direct.
[AGENT][NEUTRAL] OK, thank you and may I have the name of the facility or the provider you're calling from?
[CUSTOMER][NEUTRAL] Yes Rio Valley dermatology.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, it is 01868846.
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] It's for An[PII] date of birth is 4-[PII].
[AGENT][NEUTRAL] OK, thank you. And before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage, and that's just a disclaimer.
[AGENT][NEUTRAL] And we have an effective date of, let's see, Ma[PII]It is active at the moment and this is one of our secondary supplemental plans to the major medical. And with this one, we covered the office procedures or office treatment and we, we do not cover the office visit. Um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Bear with me just a minute, let me see how much is the maximum.
[AGENT][NEUTRAL] Um.
[AGENT][NEUTRAL] OK, the calendar year maximum is 2550 per covered person per calendar year.
[CUSTOMER][NEUTRAL] They
[CUSTOMER][NEUTRAL] Um, does it cover the deductible?
[AGENT][NEUTRAL] Yes, it covers deductibles, co-payment, and co-insurance as long as it's for a treatment or procedures done in the office. The only thing we do not cover is the co-payment for the visit.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Come with symptoms like itching.
[CUSTOMER][NEUTRAL] Oh, OK, so if she has a procedure it would be covered. Alright, let me see uh.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, mhm.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Give me a minute
[CUSTOMER][NEUTRAL] No cancer mimics negative, OK.
[CUSTOMER][POSITIVE] So it's gonna be you're welcome have a nice day, ma'am.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Do you need any other information?
[CUSTOMER][NEUTRAL] Can I get a call reference for today?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Can I get the spelling of your name please?
[AGENT][NEUTRAL] Sure. That's S [PII]Last initial M [PII].
[CUSTOMER][POSITIVE] Alright thank you so much mom.
[AGENT][POSITIVE] You're welcome and thank you for calling APO. Have a good day, Ms. To[PII].
[CUSTOMER][NEUTRAL] Bye ma'am.
[AGENT][NEUTRAL] Bye bye.