AccountId: 011433970860
ContactId: 163e2589-eb80-47dc-b573-bb2117c4f31b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 248940 ms
Total Talk Time (AGENT): 85109 ms
Total Talk Time (CUSTOMER): 75118 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/163e2589-eb80-47dc-b573-bb2117c4f31b_20250408T13:21_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from provider's office. May I know the member eligibility and benefits?
[AGENT][NEUTRAL] Sure, I can assist you with that. Could you provide me with the spelling of your name and a callback number?
[CUSTOMER][NEUTRAL] Um, [PII]
[AGENT][NEUTRAL] Thank you [PII]. What's your call back number and that policy number?
[CUSTOMER][NEUTRAL] OK. Uh my callback number is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] This is my mail address number.
[AGENT][NEUTRAL] Thank you. And what's the policy number of the member?
[CUSTOMER][NEUTRAL] OK. Policy number is um just a minute.
[CUSTOMER][NEUTRAL] 02
[CUSTOMER][NEUTRAL] 49
[CUSTOMER][NEUTRAL] 76
[CUSTOMER][NEUTRAL] 27
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] ML 8.
[AGENT][NEUTRAL] Thank you, [PII]. What is the member's name and date of birth?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] [PII]. Date of birth is uh [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] And you're calling to verify benefits and eligibility for what place of service?
[CUSTOMER][NEUTRAL] His office visit. Actually, [PII] is primary is showing for a secondary or supplementary plan or uh commercial plan.
[AGENT][NEUTRAL] Yes, this policy has been active since [PII] and it's currently active. You're calling to verify office visits. The member has office visit pays up to $25 per visit or $50 per visit for a specialist, and this is not a guarantee of benefits, just a disclaimer of the policies the coverage and the member has 4 visits per calendar year.
[AGENT][NEUTRAL] And they've only utilized one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Uh, this is secondary insurance, right?
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] OK. May I know the and the benefits will be primary uh deductible copay will be covered?
[AGENT][NEUTRAL] Repeat yourself.
[CUSTOMER][NEUTRAL] OK. Uh, yeah, primary co-pay, deductible will be covered for secondary insurance.
[AGENT][POSITIVE] Yes, that is correct. Yes.
[CUSTOMER][NEUTRAL] Copay also will be covered.
[AGENT][NEUTRAL] Yes, this policy is a gap insurance to assists with deductible, co-pay and co-insurance to the primary.
[CUSTOMER][NEUTRAL] OK. Uh, only deductible will be covered.
[AGENT][NEUTRAL] Deductible, co-pay, and co-insurance. Are you not able to hear me, [PII]?
[CUSTOMER][NEUTRAL] OK. OK. May I know the effective date and termination that policy?
[AGENT][POSITIVE] Sure, give me one moment. I can give you that again.
[CUSTOMER][NEUTRAL] Hm
[AGENT][NEUTRAL] This member's policy has been active since [PII] and it's currently active. Is there anything else that I could assist you with today?
[CUSTOMER][NEUTRAL] OK, may I know the uh call reference number, please?
[AGENT][NEUTRAL] We don't provide those unfortunately you can use my name in today's date as a reference. My name is [PII].
[AGENT][NEUTRAL] [PII], in today's date. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] That's
[CUSTOMER][POSITIVE] OK, thank you, sir. Thank you for the information. Thank you.
[AGENT][POSITIVE] Thanks for calling APL and have a great day. Goodbye.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 11258433.
[AGENT][NEUTRAL] Go sit down.