AccountId: 011433970860
ContactId: 0f10503b-ecfd-4752-89cd-0b04a19c1d8d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 136080 ms
Total Talk Time (AGENT): 64811 ms
Total Talk Time (CUSTOMER): 45293 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/0f10503b-ecfd-4752-89cd-0b04a19c1d8d_20250513T14:15_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, yes, I just needed to run eligibility and benefits for a patient please.
[AGENT][POSITIVE] Sure, I can assist you with that. Can I have your name and a callback number?
[CUSTOMER][NEUTRAL] Yes, my name is [PII] and callback number is [PII].
[AGENT][NEUTRAL] And what is the policy number of the member that you're calling to verify benefits and eligibility for?
[CUSTOMER][NEUTRAL] Um, I have 02141258.
[CUSTOMER][NEUTRAL] M as in Mary, L as in Lima, and then the number [PII].
[AGENT][NEUTRAL] You verify that patient's name and date of birth.
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] And her date of birth?
[CUSTOMER][NEUTRAL] Is [PII].
[AGENT][NEUTRAL] And you're calling to verify benefits and eligibility for what place of service and what was your name?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Oh, [PII].
[CUSTOMER][NEUTRAL] And we are ophthalmology.
[AGENT][NEUTRAL] So that's the office visit, this policy has been active since [PII] and is currently active.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] The policy does not have cover office visits, however, the treatment received in the office falls under her outpatient benefits.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And her outpatient benefits, um, is $500 per calendar day and this is not a guaranteed benefits just a disclaimer of the policy's coverage and when I say the treatment received in the office, meaning as in the office visit itself is not covered, but any type of procedure that's performed in the office would be covered under the outpatient benefits. And if not, if possible, could you provide me with the spelling of your name again and that callback number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] And the callback number is [PII].
[AGENT][NEUTRAL] So I have [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you. Is there anything else that I can assist you with today?
[CUSTOMER][POSITIVE] No, that's it for today thank you so much.
[AGENT][POSITIVE] Thanks for calling APL and you have a great day.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][NEUTRAL] Bye.