AccountId: 011433970860
ContactId: 38a35df3-a310-48d4-8c5a-3d04e8f69e0a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 227889 ms
Total Talk Time (AGENT): 89852 ms
Total Talk Time (CUSTOMER): 69366 ms
Interruptions: 2
Overall Sentiment: AGENT=0.7, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/19/38a35df3-a310-48d4-8c5a-3d04e8f69e0a_20250619T15:01_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Good day. This is [PII] from provider's office. I'm just calling to check for benefits and eligibility.
[AGENT][NEUTRAL] Sure, I can assist you with that. Did, could you provide me with the spelling of your name and a callback number?
[CUSTOMER][NEUTRAL] Mhm. It is [PII], and that's for my last name initial. For my callback number, it is [PII].
[AGENT][NEUTRAL] [PII], what is the policy number of the member that you're calling to verify eligibility for?
[CUSTOMER][NEUTRAL] Um, this is for your policy 2483111.
[AGENT][NEUTRAL] And could you verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, it's for [PII]. Date of birth of [PII].
[AGENT][NEUTRAL] This policy has been active since [PII] and it's currently active. You're calling to verify benefits eligibility for what place of service?
[CUSTOMER][NEUTRAL] Um, just for a specialist, and I just want to ask about the maximum benefit.
[AGENT][NEUTRAL] So this member's policy does not cover office visits, only the treatment received in the office.
[AGENT][NEUTRAL] So the office visit?
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Mm, um, how about for the maximum benefits?
[AGENT][NEUTRAL] The maximum benefit amount for.
[AGENT][NEUTRAL] What benefit amount for what what place of service or offices is not covered, so would you like the outpatient benefits?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Oh, yes, outpatient benefits, sorry.
[AGENT][POSITIVE] No worries. I just wanna make sure that I give you the detailed information so you won't be confused when you get off the phone.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Outpatient so the members that has outpatient benefits.
[AGENT][NEUTRAL] Of 9000.
[AGENT][NEGATIVE] $100 per calendar year and this is not a guaranteed if it's just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] Mhm. And is there any um amount used already out of 9100?
[AGENT][NEUTRAL] Mm, uh.
[AGENT][NEUTRAL] The member has used utilize $5,191.20 of the benefits for outpatient services.
[CUSTOMER][NEUTRAL] I'm sorry, can you repeat that one? Um, the line is cutting in and out on the part.
[AGENT][NEUTRAL] $5,191.20 has been utilized for 2025.
[CUSTOMER][NEUTRAL] Mhm. OK. So 5191.20. Am I right?
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And we just have as well a reference number. And what was your name again?
[AGENT][NEUTRAL] We don't provide those. [PII], unfortunately, however, you can use my name in today's date as a reference. It's [PII].
[CUSTOMER][POSITIVE] Mhm. OK. Thank you very much. You have a great.
[AGENT][NEUTRAL] Is there anything else that I can assist you with today?
[CUSTOMER][POSITIVE] Um, that's all for me. Thank you.
[AGENT][POSITIVE] Thanks for calling APL and have a great day.
[CUSTOMER][POSITIVE] Thank you. Have a great day.