AccountId: 011433970860
ContactId: 3eed6980-0729-4511-8f71-e157f155f5c4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 235710 ms
Total Talk Time (AGENT): 134691 ms
Total Talk Time (CUSTOMER): 63486 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/19/3eed6980-0729-4511-8f71-e157f155f5c4_20250519T18:15_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Um, hi, [PII]. I would just like to get uh benefit information for one of our patients.
[AGENT][POSITIVE] Alright, I'll be glad to help you. Go and give me your name and the member's policy number, please.
[CUSTOMER][NEUTRAL] Uh my name is [PII], and the policy number is 02610391.
[AGENT][NEUTRAL] Alright, thank you for all that information. Now while I'm pulling this up, go ahead and give me a good return telephone call number, please.
[CUSTOMER][NEUTRAL] My callback number is [PII].
[AGENT][POSITIVE] Alrighty, thank you so much for all the information though. Now your patient's name and date of birth.
[CUSTOMER][NEUTRAL] Um, it would be [PII], [PII]. And can I also, can you spell your name, please?
[AGENT][NEUTRAL] Alright.
[AGENT][NEUTRAL] Oh, I sure can. It's [PII] yes. Last name it starts with an [PII]
[CUSTOMER][NEUTRAL] And your initial?
[CUSTOMER][POSITIVE] Oh, thank you.
[AGENT][NEUTRAL] Yes, OK, [PII], that, uh, you're welcome. OK, now [PII], you're calling to get benefits, uh, on [PII], is that correct?
[CUSTOMER][NEUTRAL] Yes, can I have the effective date of the plan? Is the plan active?
[AGENT][NEUTRAL] Yes, ma'am. OK, well, we are, of course, is her medical supplemental plan. So the only thing that we would pick up and pay on is for sickness and injury. Excuse me.
[AGENT][NEUTRAL] Excuse me, I'm so sorry. That is applied towards her deductible copay or co-insurance at her primary insurance carrier. Now, I do show her original effective date is [PII]. She is current and active, but I must advise that verification of coverage is not a guarantee of benefits. But are you needing the exact benefit on something or just her eligibility today?
[CUSTOMER][NEUTRAL] Uh, specialist office visit. Is that covered?
[AGENT][NEUTRAL] Oh, alrighty, let me get over to her benefits. Let's see.
[AGENT][NEGATIVE] All right, that's like under this plan, she does not have any type of office visit benefits here at all.
[CUSTOMER][NEUTRAL] Uh, is there an outpatient benefit maximum?
[AGENT][NEUTRAL] There is an outpatient benefit. Let's see what that max is.
[CUSTOMER][NEUTRAL] And what's the accumulation?
[AGENT][NEUTRAL] I'm sorry, what was that?
[CUSTOMER][NEUTRAL] Uh, the accumulation if there's, uh, an outpatient benefit max.
[AGENT][NEUTRAL] 00, if any is used, OK. Uh, let's see. My computer is moving a little slow, so bear with me. Let's see.
[AGENT][NEUTRAL] Well, that looks like she has an outpatient max of $1500 per calendar year and she's not used anything as of today.
[CUSTOMER][NEUTRAL] Got it. Can I have a reference number, please?
[AGENT][NEUTRAL] Well, we don't give reference numbers with you, but you can use my name in today's date, and is that all that I can help you with today?
[CUSTOMER][POSITIVE] Yep, that's all for today. Thank you so much, [PII].
[AGENT][POSITIVE] Well, yes, ma'am, and thank you for calling APO and you have a great rest of your day, [PII].
[CUSTOMER][POSITIVE] You too. Bye-bye. Take care.
[AGENT][POSITIVE] Thank you, ma'am. Uh-huh, you too. Bye-bye.