AccountId: 011433970860
ContactId: 10cd335e-291e-416f-b285-aebbb3e1b60c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 237410 ms
Total Talk Time (AGENT): 88324 ms
Total Talk Time (CUSTOMER): 74401 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/10cd335e-291e-416f-b285-aebbb3e1b60c_20250529T18:05_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], good day. My name is [PII]. I'm calling from the doctor's office to check eligibility and benefits on the member's plan.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the eligibility and benefits. And [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Uh, sure. Callback number, that's [PII]. And the uh policy number, I have 2483111.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes, name is [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment, and I am showing the policy is active. It's been effective since [PII].
[AGENT][NEUTRAL] And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] Um, may I know if, uh, I have a code to check, ma'am. Do you check procedure codes?
[AGENT][NEUTRAL] No, we don't. Um, are you considered an inpatient or outpatient facility?
[CUSTOMER][NEUTRAL] Outpatient, outpatient facility.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] So for outpatients,
[CUSTOMER][NEUTRAL] Uh, done in specialist office.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Hi
[CUSTOMER][NEUTRAL] Done in a specialist office.
[AGENT][NEUTRAL] So for outpatient, the policy will pay up to $9100 per calendar year. Um, did you want me to see if any of that has been used for this year?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So she's used $5160.27.
[AGENT][NEUTRAL] She has a total of $3,939.73 left for 2025.
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Uh yes, ma'am. Again, 5160 and 27 cents has been.
[AGENT][NEUTRAL] That's how much has been used. She has $3,939.73 left for the year.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Alright thank you so much.
[AGENT][POSITIVE] You're very welcome. Was there anything else I could?
[CUSTOMER][NEUTRAL] And may I know your office visits are covered?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Uh, may I confirm if office visits are covered?
[AGENT][NEUTRAL] Yes, that's what we just went over.
[AGENT][NEUTRAL] So that's that's under outpatient?
[CUSTOMER][POSITIVE] OK, thank you so much, [PII].
[CUSTOMER][POSITIVE] OK. Thank you so much, [PII].
[AGENT][NEUTRAL] Was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Um, can I also get your last name initially and the reference number for this call?
[AGENT][NEUTRAL] Sure, it's L like Larry, and there's no call reference number, but you can use my name in today's date.
[CUSTOMER][POSITIVE] OK, thank you again you have a great day.
[AGENT][POSITIVE] You also, thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Alright bye bye.