AccountId: 011433970860
ContactId: 3820daa6-96fb-4239-b1dd-31287eec377a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 140550 ms
Total Talk Time (AGENT): 75458 ms
Total Talk Time (CUSTOMER): 47247 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/3820daa6-96fb-4239-b1dd-31287eec377a_20250110T21:53_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] last name [PII] it's [PII] [PII] I would like to check eligibility in benefits, please.
[AGENT][POSITIVE] Yeah, I could take eligibility and benefits for you, [PII]. Uh, can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Yes, it will be [PII].
[AGENT][NEUTRAL] OK, thank you and then do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, policy number is 01792111.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Yes, [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that, [PII]. Uh, so this policy is active. Effective date was [PII], and this is a secondary medical policy. It is designed to help with co-pay, deductible and co-insurance after major medical pays, and we need to check outpatient benefits.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims.
[AGENT][NEUTRAL] The outpatient benefit is $5000 max per calendar year.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] If you'll give me one moment I'll see if any of that has been used.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, none of that has been used so far this year.
[CUSTOMER][NEUTRAL] OK, got it, thank you and yep, uh, is that all the benefits that this patient have?
[AGENT][NEUTRAL] Oh, they have inpatient benefits as well. Did you want me to look at that for you?
[CUSTOMER][NEUTRAL] I don't know it's OK, no worries, just for the outpatient.
[AGENT][NEUTRAL] OK, OK, yeah, that's their outpatient benefit.
[CUSTOMER][NEUTRAL] OK, yeah,
[CUSTOMER][NEUTRAL] OK, can I have the reference number please and can you spell your name to me?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date. Uh so my name is spelled [PII] Last initial [PII], and was there anything else I could help you with?
[CUSTOMER][POSITIVE] Everything is good now, thank you so much have a great day.
[AGENT][POSITIVE] Alright, thank you for calling APL you too bye bye. Thank you.
[CUSTOMER][POSITIVE] Take care.