AccountId: 011433970860
ContactId: 43e2bbb4-e84c-4070-a091-6fcc5aa91835
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 149490 ms
Total Talk Time (AGENT): 74908 ms
Total Talk Time (CUSTOMER): 41402 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/12/43e2bbb4-e84c-4070-a091-6fcc5aa91835_20250212T17:45_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]. It's spelled [PII] I'm calling from Prima Health and I want to verify patients benefits eligibility.
[AGENT][POSITIVE] Yeah, I get your benefits and eligibility for you. Uh, [PII], can I get a good call back number from you first in case we're disconnected please?
[CUSTOMER][NEUTRAL] Yes, it's [PII]. No extension.
[AGENT][NEUTRAL] Thank you, and then can I get the policy number please?
[CUSTOMER][NEUTRAL] Yes, it's uh 01687790.
[AGENT][NEUTRAL] OK, thank you. And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] It's uh [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that [PII]. Uh, so this policy is active. Effective date was uh [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And this is a limited indemnity medical plan, so it essentially pays a set dollar amount per covered procedure or office visit.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I'm sorry, what was the amount?
[AGENT][NEUTRAL] That's OK. Um, for what kind of procedure?
[CUSTOMER][NEUTRAL] It's a sick office visit for primary care?
[AGENT][NEUTRAL] Take office visit? OK, one moment, let me take a look at that.
[AGENT][NEUTRAL] OK, and of course I will let you know on the verification of coverage is not a guarantee of payment for claims, so that benefit amount would be $75 max per visit.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And that is limited to 5 visits per calendar year.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, and how many remaining for this year?
[AGENT][NEUTRAL] Let me see if any has been used. Give me just a moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, none has been used so far this year.
[CUSTOMER][NEUTRAL] OK. I just need your name and call reference number, please.
[AGENT][NEUTRAL] Sure, reference number would just be my first name, last initial, and today's date. Uh, so my name is spelled [PII] Was there anything else I could help you with for [PII]?
[CUSTOMER][POSITIVE] No, thank you so much.
[AGENT][POSITIVE] OK, yeah, thanks for calling AL. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you, bye.