AccountId: 011433970860
ContactId: 14f40d0b-f33d-405f-9521-326bec37f583
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 253020 ms
Total Talk Time (AGENT): 115119 ms
Total Talk Time (CUSTOMER): 53570 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/11/14f40d0b-f33d-405f-9521-326bec37f583_20250611T17:43_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] Of course it is
[CUSTOMER][NEUTRAL] Give me 1 2nd, I'm sorry.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hi [PII], I'm so sorry. I'm calling for Cancer Healthcare Associate. I was trying to get eligibility and benefits from one of my patients, please.
[AGENT][NEUTRAL] Hi.
[AGENT][NEUTRAL] Oh, OK, with both the eligibility and benefits, may I have your name?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][POSITIVE] Thank you and [PII]. May I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Sure, it's [PII]. Policy number is 02598409.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you for that. And can you
[AGENT][NEUTRAL] Verify the members and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So I am showing the policy is active. It's been effective since [PII].
[AGENT][NEUTRAL] Of 2
[AGENT][NEUTRAL] And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] For office visit please.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] I'm just waiting for the benefits to populate here.
[AGENT][NEUTRAL] So for the outpatient calendar year max, the policy will pay up to $1250 per person per calendar year. Um, for the office.
[AGENT][NEUTRAL] So the office setting itself, like place of service code would not be covered by the policy, but there is an office treatment rider.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So the treatment in the office could be covered up to the $1250 per calendar year, as long as it's not cosmetic.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, has he met anything um towards that 1250?
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] So he's used 200, he has 1050 left for the year.
[CUSTOMER][NEUTRAL] I'm going to watch.
[AGENT][NEUTRAL] Actually, hold on one moment.
[AGENT][NEUTRAL] Let me make sure I add this to on 1 2nd.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] So altogether he's used, so he's used 1250 of the um.
[AGENT][NEUTRAL] Physician benefit, the office treatment writer, he's used 1050 and then just for outpatient expenses, he's used 200. Um, so it's a 1250. So he's used it all for this year.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Well, so he man for this year, basically, OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, and then can I get a reference number for this call?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. The first initial and my last name is [PII], and again my name is [PII].
[CUSTOMER][POSITIVE] [PII], OK, thank you so much, [PII]. Have a good one.
[AGENT][POSITIVE] You're welcome, [PII]. Was there anything else I can help you with today?
[CUSTOMER][POSITIVE] That'd be all, thank you so much.
[AGENT][POSITIVE] Alright, thanks for calling APO you're welcome bye bye.
[CUSTOMER][NEUTRAL] Bye bye.