AccountId: 011433970860
ContactId: 268a6fdb-1a32-4af9-a8a0-afbe8d9bf8db
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 178179 ms
Total Talk Time (AGENT): 75116 ms
Total Talk Time (CUSTOMER): 57130 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/268a6fdb-1a32-4af9-a8a0-afbe8d9bf8db_20250522T15:41_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], good morning. My name's [PII]. I'm calling from provider's office to verify coverage on a member, please.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the eligibility. And [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the policy number is 022.
[CUSTOMER][NEUTRAL] 558
[CUSTOMER][NEUTRAL] 58 M as in Mary, L as in Laura number 8.
[AGENT][NEUTRAL] Thank you for that. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII] and it's [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And I am showing the policy is active. It's been effective since [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And did you need to go over benefits as well?
[CUSTOMER][NEUTRAL] Yes, I need to, um, verify benefits for outpatient.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, so for outpatient benefits, the policy will pay up to $1000 per calendar year. Um, there is a $200 deductible for the emergency room per occurrence. Did you want me to see um if she's used any of the $1000 for the year?
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And so far for [PII], I'm not showing any of the um max has been used yet.
[CUSTOMER][NEUTRAL] OK, and it's 1000, right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK, and would that cover in office surgical procedures as well?
[AGENT][NEUTRAL] Let me see if they have hold on one moment.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] I think it's not.
[AGENT][NEGATIVE] Um, no, this policy doesn't have the office treatment rider, um, so inoff coverage, uh, this policy does not have.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] No, not in the office, OK.
[CUSTOMER][NEUTRAL] OK perfect that's all I needed um can you please provide me with your name and a reference number?
[AGENT][NEUTRAL] Sure, um, so there's no call reference number, but you can use my name at today's date and that's [PII] is [PII], and then today's date.
[CUSTOMER][POSITIVE] OK perfect and thank you so much have a good one.
[AGENT][POSITIVE] You also thanks for calling APL. Bye bye.
[CUSTOMER][POSITIVE] Thank you bye bye.