AccountId: 011433970860
ContactId: 3caf7eca-5b75-458f-b0c5-aaf954ff6ee8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 184610 ms
Total Talk Time (AGENT): 88003 ms
Total Talk Time (CUSTOMER): 59811 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/3caf7eca-5b75-458f-b0c5-aaf954ff6ee8_20250624T15:34_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APR. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm calling because I have a patient in the office. I wanted to make sure the patient was active and you guys picked up the patient's copay.
[AGENT][NEUTRAL] Um, yes, ma'am. I can assist you with benefits. Um, first, could I get your name and a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Callback number is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Extension [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now, could I get the policy number, please?
[CUSTOMER][NEUTRAL] 1659605.
[AGENT][NEUTRAL] Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Yes, date of birth is [PII]. So it's [PII]
[AGENT][NEUTRAL] And just let me advise you that verification of coverage does not guarantee payment of claim.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] OK, and he does have a new policy number.
[CUSTOMER][NEUTRAL] OK, give me a second so I can update here.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK, what's the member ID, the new one, the policy?
[AGENT][NEUTRAL] The new one is 02497632.
[CUSTOMER][POSITIVE] Perfect thank you.
[AGENT][NEUTRAL] Mhm. No problem. And the effective date on this policy was [PII]. The policy is still active. And is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Outpatient, yes office specialist visit.
[AGENT][NEUTRAL] OK, for services provided in office, we cover up to $7900 per calendar year and that's for the co-insurance and the deductible after the primary insurance processes the claim and for specialist office visits, we cover up to $50 per visit and he gets 4 visits per calendar year and so far he has 3 remaining.
[CUSTOMER][NEUTRAL] OK, you guys only cover 50 you said right?
[AGENT][NEUTRAL] Right, for the copay.
[CUSTOMER][NEUTRAL] Correct. OK, so if he has to pay the 10. OK, perfect, and he's been active since [PII], is that right?
[AGENT][POSITIVE] Yes, ma'am. That's correct. That's correct. Mhm.
[CUSTOMER][NEUTRAL] With this new plan?
[CUSTOMER][POSITIVE] Perfect, can I get a reference for your name?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. My name is [PII]. Um it's spelled [PII] Last initial is [PII] and today's date. Is there anything else I can assist you with?
[CUSTOMER][POSITIVE] No, that'll be it thank you.
[AGENT][POSITIVE] OK. Thank you, [PII], for calling APL. You have a great day. Mm bye.
[CUSTOMER][POSITIVE] Thank you.