AccountId: 011433970860
ContactId: 1689939a-f01a-4ced-9e12-392194b0ce64
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 154929 ms
Total Talk Time (AGENT): 73450 ms
Total Talk Time (CUSTOMER): 49380 ms
Interruptions: 0
Overall Sentiment: AGENT=2, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/1689939a-f01a-4ced-9e12-392194b0ce64_20250428T14:08_UTC.wav
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[AGENT][POSITIVE] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm calling from Prisma Health and I want to verify patients benefits eligibility.
[AGENT][POSITIVE] Yes, ma'am. I can assist you with benefits. Um, first, could I get your name again and a good callback number?
[CUSTOMER][NEUTRAL] Yes, it's [PII]
[CUSTOMER][NEUTRAL] The callback number is [PII], no extension.
[AGENT][NEUTRAL] Thank you, [PII]. Now, could I get the policy number, please?
[CUSTOMER][NEUTRAL] Yes. It's 01807645.
[AGENT][NEUTRAL] Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII]. Date of birth [PII].
[AGENT][NEUTRAL] OK. And just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII]. The policy is still active. And is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Office visit, the office visit for primary and specialist.
[AGENT][NEUTRAL] OK. This is secondary gap insurance and what we do is cover the co-pay, the co-insurance, and deductible after the primary insurance process is declined. And for office visits, um, we cover up to $25 per visit and she gets 4 visits per calendar year.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And can you able to uh see if how many visits remaining for this year?
[AGENT][NEUTRAL] All 4 visits are remaining. She hasn't used any this year.
[CUSTOMER][NEUTRAL] OK, I need your name and the call reference number, please.
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. My name is [PII]. Um, it's spelled [PII] and my last initial is [PII], and today's date. Um, is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] OK, thank.
[CUSTOMER][POSITIVE] No, thank you so much.
[AGENT][POSITIVE] OK, thank you, [PII], for calling APL. Have a great day. Mm bye. Mhm.
[CUSTOMER][POSITIVE] Thank you. Mhm. You too. Thank you. Bye.