AccountId: 011433970860
ContactId: 16d2956a-c51b-4034-b7bf-8e637dcf28e4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 183059 ms
Total Talk Time (AGENT): 84988 ms
Total Talk Time (CUSTOMER): 65139 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/16d2956a-c51b-4034-b7bf-8e637dcf28e4_20250304T15:01_UTC.wav
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[CUSTOMER][NEUTRAL] I
[AGENT][POSITIVE] Thank you for calling APL. This is Ay[PII]How can I help you?
[CUSTOMER][NEUTRAL] Hi, you said your name is Da[PII]?
[AGENT][NEUTRAL] Um, it's Ev[PII]It's spelled E [PII]nd my last initial is M [PII].
[CUSTOMER][NEUTRAL] Hi, good morning, Easy. Uh, my name is Ja[PII]I'm calling from the office of Mora Dermatology. I'm trying to get benefits and eligibility for a mutual patient.
[AGENT][NEUTRAL] I'm sure, Ja[PII]I can assist you with benefits. Um, first, I'll need a good callback number just in case we're disconnected.
[CUSTOMER][NEUTRAL] Yes, telephone number is 30[PII].
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] Mhm. Policy number 1534941M as in Mary, L as in Lima, the number 8.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] I have here He[PII]c[PII].
[AGENT][NEUTRAL] OK, one moment, please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And just let me advise you that verification of coverage does not guarantee payment of claims. Um, he does have a new policy number.
[CUSTOMER][NEUTRAL] OK, what's the new policy number?
[AGENT][NEUTRAL] It's 02331179.
[AGENT][NEUTRAL] OK. And, yes, ma'am.
[CUSTOMER][NEUTRAL] 79
[CUSTOMER][NEUTRAL] There's no letters or anything after that is that's just a new member ID?
[AGENT][NEUTRAL] Yes, ma'am. It's just the numbers only.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. And the effective date.
[CUSTOMER][NEUTRAL] Copy let's change that.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It was Ap[PII]nd the policy is still active.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Office is it?
[AGENT][NEUTRAL] OK, for services provided in office, we cover up to $250 per day. And that's for the co-insurance and the deductible after the primary insurance processes the claim, but the co-pay for the office visit is not covered.
[CUSTOMER][NEUTRAL] OK, covers procedures and I'm sorry, you said up to 250?
[AGENT][NEUTRAL] Yes, ma'am. 250 per day.
[CUSTOMER][NEUTRAL] But.
[CUSTOMER][POSITIVE] Per day. I really love. Can I get a reference number for the call please?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. And again, my name is Ev[PII]ast in[PII] [PII]and today's date. Is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] No thank you so much easy I hope, I hope you have a great day.
[AGENT][NEUTRAL] You do the same, Ja[PII]Thank you for calling APL. Mm bye.
[CUSTOMER][POSITIVE] Thanks bye bye.