AccountId: 011433970860
ContactId: 2292fd26-7dc8-42ad-baf3-0f35772a885d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 140110 ms
Total Talk Time (AGENT): 76781 ms
Total Talk Time (CUSTOMER): 38293 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/24/2292fd26-7dc8-42ad-baf3-0f35772a885d_20250324T15:45_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, yes, I'm just calling to verify um benefits on a uh uh member.
[AGENT][POSITIVE] Yes, ma'am. I can assist you with benefits. Um, first, could I get your name and a good callback number?
[CUSTOMER][NEUTRAL] Uh yes, my name is [PII]. Uh, callback number is [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now, could I get the policy number, please?
[CUSTOMER][NEUTRAL] Uh yes, that is 02552791.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Um, patient is [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Thank you and just let me advise you that verification of coverage does not guarantee payment of claims. Um, I'm showing the effective date on this policy was [PII] and the policy is still active. Um, is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Uh, specialist office visit.
[AGENT][NEUTRAL] OK, for services provided in office, let's see, we cover up to 3000 per calendar year 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, um, and does he have a copay for?
[CUSTOMER][NEUTRAL] This plan
[AGENT][NEUTRAL] Um, no, ma'am. This is secondary gap insurance. There's probably a copay, um, under the primary insurance.
[CUSTOMER][NEUTRAL] OK. OK, got it.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um, OK, is there a call reference number?
[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. Is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] No, that's it. Thank you so much.
[AGENT][POSITIVE] OK, thank you again, [PII], for calling APL. You have a great day. Mm bye.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] OK.