AccountId: 011433970860
ContactId: 1ce8d6a2-cbc7-4259-b898-98feea6d4e35
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 195000 ms
Total Talk Time (AGENT): 85721 ms
Total Talk Time (CUSTOMER): 45856 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/20/1ce8d6a2-cbc7-4259-b898-98feea6d4e35_20250220T19:41_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yes, good afternoon. I'm calling for benefits and eligibility. please for one of our patients.
[AGENT][POSITIVE] Alright, I'm happy to check on benefits and eligibility today. Can I grab your first name, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you, [PII], and then if I can get patient policy number if you have that please.
[CUSTOMER][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] 021
[CUSTOMER][NEUTRAL] 00295
[CUSTOMER][NEUTRAL] M as in Mike. L as in Lima. 8.
[AGENT][POSITIVE] Alright thank you so much let me pull that up here.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And then if I can get patient's name and date of birth?
[CUSTOMER][NEUTRAL] Of course. The patient's name is gonna be.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Alright, thank you so much. So patient plan is active. The effective date on this is [PII]. We are the member of secondary insurance, so this is gonna cover deductible, co-pay and co-insurance that the primary does not.
[CUSTOMER][NEUTRAL] OK, so it covers office visit and outpatient surgery?
[AGENT][NEUTRAL] It does cover or excuse me, outpatient surgery, um, as far as an office visit fee, let me double check on that one second.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Yeah, no problem.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] All right, so it looks like the patient's plan does not cover any physician office visit fee, just treatment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sounds good for the outpatient surgery, so it just covers outpatient surgery, correct?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Correct, yeah.
[CUSTOMER][NEUTRAL] OK. And how much does the plan cover up?
[AGENT][NEUTRAL] You need the
[AGENT][NEUTRAL] Um, the outpatient, it looks like Benefit Max is the calendar year on this member's plan, and that is 7350.
[CUSTOMER][NEUTRAL] And how much has been accumulated per calendar year, correct?
[AGENT][NEUTRAL] Mhm, yes ma'am correct let me see what they've used.
[AGENT][NEUTRAL] Nothing has been used uh for the year thus far.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] And a reference number please?
[AGENT][NEUTRAL] It's going to be my name with my last initial in today's date. My name is [PII] spelled [PII] My last initial is [PII], and then today's date.
[CUSTOMER][POSITIVE] Thank you so much you have a great rest of your day OK?
[AGENT][NEUTRAL] You too bye bye.
[CUSTOMER][NEUTRAL] Bye