AccountId: 011433970860
ContactId: 41bd3747-60b3-4377-9349-f9f734b78c0b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 135149 ms
Total Talk Time (AGENT): 69902 ms
Total Talk Time (CUSTOMER): 56983 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/18/41bd3747-60b3-4377-9349-f9f734b78c0b_20250318T14:21_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, good morning. I'm sorry, do you need the patience, um, ID number you say?
[AGENT][NEUTRAL] I need your name and a callback number, then I need the patient's ID number.
[CUSTOMER][NEUTRAL] OK, so my name is [PII] callback number is [PII].
[CUSTOMER][NEUTRAL] That's the same.
[AGENT][NEUTRAL] And the policy number of the member and the reason for your call [PII].
[CUSTOMER][NEUTRAL] Alright, it's 02022165 and I'm calling for benefits.
[AGENT][NEUTRAL] Could you verify this patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] You're calling to verify benefits eligibility for work place of service?
[CUSTOMER][NEUTRAL] All right, outpatient, um, yeah, outpatient hospital and also for in office.
[AGENT][NEUTRAL] This member's policy has been active since [PII] and is currently active. You're calling to verify office visits and outpatient services. The policy does not cover office visits. However, the outpatient benefits, the outpatient services falls on the outpatient.
[AGENT][NEUTRAL] Benefits of 300, I'm sorry, $3500 per calendar year and this is not a guaranteed benefits just a disclaimer of the policy's coverage and the treatment received in the office falls under the outpatient benefits as well. however, the visit is not covered.
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] Alright, so you say 3500, right?
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][POSITIVE] Perfect for outpatient and also if it's done in outpatient hospital we apply as well.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Alright, do you know for inpatient if she has benefits as well would be the same amount?
[AGENT][NEUTRAL] This has inpatient benefits of $3500 per calendar year as well, and this is not a guaranteed benefits, just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] Alright, office visit on the cover.
[AGENT][NEGATIVE] No they're not.
[CUSTOMER][POSITIVE] Perfect, thank you so much. That would be all. May I have please your name and the reference number?
[AGENT][NEUTRAL] My name is [PII] and today's date as a reference. Is there anything else that I can assist you with today, yes?
[CUSTOMER][NEUTRAL] No thank you so much and have a great day.
[AGENT][POSITIVE] Thanks for calling API. You have a great one as well. Goodbye.
[CUSTOMER][POSITIVE] Thank you bye bye.