AccountId: 011433970860
ContactId: 2b2835ac-30fa-462f-82ab-cfef9368e451
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 201380 ms
Total Talk Time (AGENT): 86072 ms
Total Talk Time (CUSTOMER): 67058 ms
Interruptions: 2
Overall Sentiment: AGENT=2.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/2b2835ac-30fa-462f-82ab-cfef9368e451_20250415T16:22_UTC.wav
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[CUSTOMER][NEUTRAL] and you know.
[AGENT][POSITIVE] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Um, hi, I'm calling from Medical Group for.
[CUSTOMER][NEUTRAL] Eligibility and benefits.
[AGENT][NEUTRAL] Let's check eligibility and benefits for you. What was your name?
[CUSTOMER][NEUTRAL] [PII]?
[AGENT][NEUTRAL] OK [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII] excuse me.
[AGENT][NEUTRAL] OK and then do you have that policy number?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] 02474390.
[AGENT][NEUTRAL] OK, and what was the name and date of birth for the member, please?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that. Uh, so this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays. And we we needing to look at uh inpatient or outpatient benefits?
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Why are you?
[CUSTOMER][NEUTRAL] Oh, you're gonna.
[CUSTOMER][NEUTRAL] Outpatient free, uh, specialist office visit.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, of course I will let you know verification of coverage is not a guarantee of payment for claims. Give me just a moment. I'm going to check to see if office visits are covered under this policy. I will say that the outpatient benefit is on a per calendar day basis, so it pays up to $500 per calendar day.
[CUSTOMER][NEUTRAL] So how was it.
[AGENT][NEUTRAL] Bear with me just a moment.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Oh she became more.
[AGENT][POSITIVE] OK, I appreciate your patience. Thank you so much. Uh, so that is no office visits including specialists are covered under this policy.
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] Oh, OK, so now let me write it down.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Not this because it's covered under policy including specialist.
[AGENT][POSITIVE] Right. Correct.
[CUSTOMER][NEUTRAL] OK, so then, OK, so then it would not cover the copay for her primary insurance.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um, thank you. May I have a call reference number?
[AGENT][NEUTRAL] Sure, that would just be my first name, last initial, and today's date. Uh, so my name is spelled [PII] That's OK, it's [PII] Was there anything else I can help you with, [PII]?
[CUSTOMER][NEUTRAL] I'm sorry I didn't uh.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Oh no, that was it thank you very much.
[AGENT][POSITIVE] Alright, yeah, thanks for calling HPL. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you you too bye.
[AGENT][POSITIVE] Thank you. Bye-bye.