AccountId: 011433970860
ContactId: 32c3e23b-b508-4f0a-b198-a30ce1fb07f9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 165389 ms
Total Talk Time (AGENT): 80800 ms
Total Talk Time (CUSTOMER): 50298 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=1.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/32c3e23b-b508-4f0a-b198-a30ce1fb07f9_20250117T14:34_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, yes, Miss [PII]. I'm calling from my doctor's office. I'm a mutual patient and needed um benefit information. Is this a secondary insurance or insurance.
[AGENT][POSITIVE] OK, well, I can definitely help you with the benefits. And may I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, my name is [PII] and my phone number is [PII].
[AGENT][NEUTRAL] Thank you for that. And [PII], may I have the member's policy number?
[CUSTOMER][NEUTRAL] It is 02562814.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] it's [PII] Date of birth, Give me a second, I'm on the wrong screen.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So I am showing the policy is active, it's been effective since [PII]. And let me see.
[AGENT][NEUTRAL] This is their Metlink policy, um, so we applied to the co-pay, deductible and co-insurance after their primary, um, of covered charges. Are you all considered like outpatient or would this be inpatient?
[CUSTOMER][NEUTRAL] Outpatients, the doctor's office.
[AGENT][NEUTRAL] OK. Let me see. Hold on one moment for doctor's office.
[AGENT][NEUTRAL] OK, so for outpatient, we will pay up to $5000 per calendar year, um, and that does, let me see.
[CUSTOMER][NEUTRAL] What does it include? Does it include the copay, deductible and coinsurance, or just that the one coinsurance?
[AGENT][NEUTRAL] We pay towards the co-pay, deductible or co-insurance of cover charges. So it could be all three or depends on what's submitted.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK, now, has any of it been met?
[AGENT][NEUTRAL] For [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Um, for [PII], she has not used any of the benefits yet.
[CUSTOMER][POSITIVE] Awesome, can I have a a reference number?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name and today's date and that's [PII].
[CUSTOMER][POSITIVE] Perfect, thank you, Ms. [PII], you have a super day.
[AGENT][POSITIVE] You also [PII] and thanks for calling APL. Bye-bye.
[CUSTOMER][POSITIVE] You're welcome bye bye.