AccountId: 011433970860
ContactId: 3591b064-01f9-4017-b613-1120682b6ee2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 227649 ms
Total Talk Time (AGENT): 93193 ms
Total Talk Time (CUSTOMER): 91130 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/20/3591b064-01f9-4017-b613-1120682b6ee2_20250520T14:36_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] Hello, good morning. My name is [PII] Last initial is [PII] and I'm calling for eligibility and benefits for patients.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the eligibility and benefits. And may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Can I have it.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Yeah, it's uh [PII] that's the direct line and then policy number would be 02596762.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Here we go. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is um [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].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] Do you need the CPT code and the procedure code or just like an office specialist?
[AGENT][NEUTRAL] Um, yeah, just like is it inpatient or outpatient and you said office?
[CUSTOMER][NEUTRAL] Yes, um,
[CUSTOMER][NEUTRAL] Oh, and yeah, office specialist and patient.
[CUSTOMER][NEUTRAL] not
[AGENT][NEUTRAL] You said inpatient?
[CUSTOMER][NEUTRAL] Mhm, yes.
[AGENT][NEUTRAL] So they're being admitted?
[CUSTOMER][POSITIVE] No, I'm sorry, outpatient. I'm sorry.
[AGENT][NEUTRAL] It's OK. OK, so for outpatient, the policy is, uh, the max is $2550 per calendar year. Did you want me to see if any has been used?
[CUSTOMER][NEUTRAL] But.
[CUSTOMER][NEUTRAL] Yes, please, 2, 2550, right? 2550, uh huh.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][POSITIVE] Mhm. That's correct.
[AGENT][NEGATIVE] And so far none of the benefits have been used for [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Do they have a um copay?
[AGENT][NEUTRAL] Oh, well, our policy is the 2nd secondary, so we pay towards the copay, deductible and co-insurance after primary.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So and then do they have after the deductible has been met, they have a co-insurance or?
[AGENT][NEUTRAL] Mhm. So primary is going to apply the copay or set the deductible and then our policy helps pay it, so up to that $2550.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, you take
[CUSTOMER][NEUTRAL] OK, and nothing has been used, right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] 2550.
[CUSTOMER][NEUTRAL] OK, may I have a reference number for this call, please?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. First initial to my last name is [PII].
[CUSTOMER][NEUTRAL] Mhm first name?
[AGENT][NEUTRAL] My name is [PII]
[CUSTOMER][POSITIVE] Alright, OK, thank you so much, [PII]. You have a good day.
[AGENT][NEUTRAL] You're welcome, [PII]. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] No.
[AGENT][POSITIVE] Alright, thanks for calling APL. Bye-bye.
[CUSTOMER][POSITIVE] You have a good day. Yes, bye bye.