AccountId: 011433970860
ContactId: 0ee287a4-48df-45e1-baa3-4760fb0ac1ea
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 154380 ms
Total Talk Time (AGENT): 87627 ms
Total Talk Time (CUSTOMER): 51305 ms
Interruptions: 0
Overall Sentiment: AGENT=2.5, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/0ee287a4-48df-45e1-baa3-4760fb0ac1ea_20250407T15:05_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning [PII]. My name is [PII]. I'm calling from my doctor's office, and I needed to check benefits for a patient, please.
[AGENT][NEUTRAL] I can help you with that, [PII]. What is a good callback number, please?
[CUSTOMER][NEUTRAL] Direct is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And the policy number for the patient, please?
[CUSTOMER][NEUTRAL] 02357655 ML 8.
[AGENT][POSITIVE] Thank you, [PII].
[AGENT][NEUTRAL] And the patient's name and date of birth, please.
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And I do apologize, are you needing eligibility or claim status?
[CUSTOMER][NEUTRAL] Eligibility.
[AGENT][NEUTRAL] All right, I can help you with that, and I apologize, I didn't write it down. [PII], I am showing that [PII]'s policy is active. Effective date is [PII], and this is a secondary policy to her primary insurance. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] No worries.
[CUSTOMER][NEUTRAL] So let me ask you, do you, um, do you guys cover like co-payments or deductibles?
[AGENT][NEUTRAL] Is it for an office visit, [PII]?
[CUSTOMER][NEUTRAL] No, it's gonna be for um it's for a procedure done in the hospital outpatient.
[AGENT][NEUTRAL] Yes, ma'am. Um, this policy pays to the deductible, co-pay or co-insurance for the covered outpatient charges. Do you need that benefit amount?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Sure, yes, please.
[AGENT][NEUTRAL] Alright, that benefit amount we can pay up to $750. That is a per calendar day benefit, and that is a verification of coverage and not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK, you said per day correct?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][POSITIVE] OK, 750 per day. Alright, pays deductible and co-payments. OK, awesome, thank you so much. May I have a reference number please?
[AGENT][POSITIVE] The reference number would be my name and today's date, and I spell my name [PII]. And [PII], it was a pleasure to help you with those benefits as well. Anything else I can help you with?
[CUSTOMER][POSITIVE] No, that's it thank you I appreciate it.
[AGENT][POSITIVE] And thank you for calling APL. I hope you have a wonderful day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye-bye.