AccountId: 011433970860
ContactId: 44d3a0c2-c981-41a7-a434-ee68495107cd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 211559 ms
Total Talk Time (AGENT): 93123 ms
Total Talk Time (CUSTOMER): 87003 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/11/44d3a0c2-c981-41a7-a434-ee68495107cd_20250311T18:35_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] in customer services. How are you?
[AGENT][POSITIVE] Hey [PII], I'm good. How are you?
[CUSTOMER][NEUTRAL] I'm good. I have a provider on the phone and I've been trying to transfer her to benefits uh for HR policy, but nobody will answer the phone.
[AGENT][POSITIVE] Oh, OK. If she just needs to verify benefits, I can definitely help with that, [PII], no worries.
[CUSTOMER][NEUTRAL] OK, um, oh, let me pull up the right screen.
[CUSTOMER][NEUTRAL] I was doing something while I was.
[CUSTOMER][NEUTRAL] OK, it's on policy 249.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 6241
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have [PII] on the phone, [PII]
[CUSTOMER][NEUTRAL] And she's calling on something cruise and I did verify the date of birth.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Alright awesome thank you [PII] you can send him over.
[CUSTOMER][POSITIVE] All right, thank you. Here she is.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Hi, this is [PII] with APL. Am I speaking with [PII]?
[CUSTOMER][NEUTRAL] Yes, that is me.
[AGENT][NEUTRAL] Hi, I understand that you just need to verify benefits and eligibility for a patient. Is that correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] All right. If I could just get the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Um, first name I'm gonna spell it out for you, um, [PII]
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Last name [PII]
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, date of birth is [PII].
[AGENT][POSITIVE] All right. Thank you so much for that. So the patient is active. The effective date on this is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then what other benefits did you need from the member's plan, if any?
[CUSTOMER][NEUTRAL] Is there, does he have a copay?
[AGENT][NEUTRAL] So there is no co-pay. This is a limited benefit, uh, hospital indemnity plan. So is the patient coming in for like an office visit with a doctor?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, so let's see.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] So it looks like under this patient's plan, they are permitted up to.
[AGENT][NEUTRAL] 6 physician office visits in a calendar year.
[AGENT][NEUTRAL] And the patient's plan is gonna pay $75 towards the visit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then is there like an auto network or out of network?
[CUSTOMER][NEUTRAL] Or can you check to see if we're in network?
[AGENT][NEUTRAL] No, there's no network required for usage um it's like I said just that set amount that it will pay towards the office visit it's not gonna pay anything more or less even if you're in or out of network.
[CUSTOMER][POSITIVE] OK awesome.
[CUSTOMER][NEUTRAL] Alrighty, that was our only question.
[AGENT][NEUTRAL] Anything else?
[AGENT][POSITIVE] Alright sounds good thanks for calling APL have a great day.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] Bye bye.