AccountId: 011433970860
ContactId: 1b97f846-2b56-483f-8778-a2f598e5d0c0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 247320 ms
Total Talk Time (AGENT): 98366 ms
Total Talk Time (CUSTOMER): 63345 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/25/1b97f846-2b56-483f-8778-a2f598e5d0c0_20250225T17:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, we're calling. This is Highland and theonics. We're calling on behalf of our patient [PII].
[AGENT][POSITIVE] All right. I'm happy to help. How can I help?
[CUSTOMER][NEUTRAL] We need benefits and eligibility.
[AGENT][NEUTRAL] All right. Do we have her policy number?
[CUSTOMER][NEUTRAL] 587-410-122
[AGENT][NEUTRAL] Is that maybe her social?
[CUSTOMER][NEUTRAL] I don't see and I've tried almost everything and it's still.
[AGENT][NEUTRAL] OK, let me try it as a social and see if that, if not, I can check my name. Let me see.
[CUSTOMER][NEUTRAL] Not
[AGENT][NEUTRAL] First name was [PII], correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] OK, thank you so much. And then what is [PII]'s date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright
[AGENT][NEUTRAL] Patient does have an active plan. The effective date is [PII]. Do you need the actual policy number?
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Um, the member ID?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, if it's a is it a different one?
[AGENT][NEUTRAL] Yeah, it's different than what you had given me that was the member's social.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, let me mark this out.
[AGENT][POSITIVE] No worries.
[CUSTOMER][NEUTRAL] OK, what's that Ay?
[AGENT][NEUTRAL] Um, it's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then did you need a fax back with the benefits?
[CUSTOMER][NEUTRAL] Or I just need the maximum deductible.
[AGENT][NEUTRAL] OK, let me just pull it here. Give me one second.
[AGENT][NEUTRAL] OK, so it looks like the calendar year maximum under the patient plan is $1250. The calendar year deductible is going to be $50 per covered insured. It does carry $150 per family.
[CUSTOMER][NEUTRAL] OK, what's hers the, what is she under?
[CUSTOMER][NEUTRAL] The individual or family?
[AGENT][NEUTRAL] Oh, she's just individual. I apologize, yeah.
[CUSTOMER][NEUTRAL] OK, and her deductible is still 50%?
[AGENT][POSITIVE] Uh yes, correct.
[CUSTOMER][NEUTRAL] And then what's her maximum?
[AGENT][NEUTRAL] The calendar maximum is 1250.
[CUSTOMER][NEUTRAL] OK, and then what's the remaining?
[AGENT][NEUTRAL] The remaining balance left is $545.60.
[CUSTOMER][NEUTRAL] OK, and then do you have the preventative and diagnostic and basic and major?
[CUSTOMER][NEUTRAL] Percentages.
[AGENT][NEUTRAL] Yeah, so it looks like preventative is going to be at 100%.
[CUSTOMER][NEUTRAL] And then Indo
[AGENT][NEUTRAL] Uh, let's see, is that 50%?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then the basic is at 80.
[CUSTOMER][NEUTRAL] And and those covered at 50.
[AGENT][NEUTRAL] Mhm. Correct. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, and then post and core.
[AGENT][NEUTRAL] It looks like that's 50 also.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Right, that's all I needed. Thank you so much.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye-bye.