AccountId: 011433970860
ContactId: 1ca12b3d-15ed-469a-bc0e-4779ba53cb0e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 132919 ms
Total Talk Time (AGENT): 77780 ms
Total Talk Time (CUSTOMER): 44638 ms
Interruptions: 0
Overall Sentiment: AGENT=2.3, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/18/1ca12b3d-15ed-469a-bc0e-4779ba53cb0e_20250318T18:08_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling the EPL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] from South Carolina Sleep Medicine. I am calling to get eligibility and benefits on an outpatient sleep study on a member.
[AGENT][POSITIVE] Well [PII], it would be a pleasure to help you with those benefits. What is a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII], and what is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] It's A as in apple, H as in Howard, 0587460.
[AGENT][NEUTRAL] Is that your primary insurance policy number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, do you have the APL policy certificate number?
[CUSTOMER][NEUTRAL] Um, I do. It is 225-207-6.
[AGENT][NEUTRAL] All right, thank you. And what is the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] All right, thank you. It would be my pleasure to assist you with eligibility and benefits for [PII]. I'm showing that her policy is active. Effective date is [PII].
[AGENT][NEUTRAL] And you were needing outpatient facility benefits for sleep study?
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] OK, she does have outpatient coverage up to $4800 per calendar year. Now there is a $100 deductible that has not been met, and once that deductible has been met, then we can pay up to $4800.
[AGENT][NEUTRAL] And none of her benefits have been used either as for [PII]. The benefits are a verification of coverage, not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else I can help you with, [PII]?
[CUSTOMER][NEUTRAL] more
[CUSTOMER][POSITIVE] No ma'am that's it thank you so much.
[AGENT][POSITIVE] It's been a pleasure to assist you with those benefits, [PII]. Thank you for calling APL and I hope you have a wonderful day.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][POSITIVE] Thank you bye bye.