AccountId: 011433970860
ContactId: 48f64681-d2f1-4aaa-bbb0-73e00ad9cef9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 157330 ms
Total Talk Time (AGENT): 56403 ms
Total Talk Time (CUSTOMER): 64607 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/48f64681-d2f1-4aaa-bbb0-73e00ad9cef9_20250513T14:47_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]. Yes, I was calling to get um benefits and eligibility for one of your members, please.
[AGENT][NEUTRAL] All right, I'm happy to check on benefits and eligibility. What is the policy number for the patient?
[CUSTOMER][NEUTRAL] 01606502 ML 8.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And then for documentation, could I get your name and a callback number?
[CUSTOMER][NEUTRAL] [PII] last name to my initial is [PII] phone number [PII].
[AGENT][NEUTRAL] Thanks, [PII]. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It is um [PII].
[AGENT][NEUTRAL] Patient is active, effective date is [PII]. We're the member secondary insurance so this covers deductible, co-pay, co-insurance, the primary does not.
[CUSTOMER][NEUTRAL] OK, and what is um.
[CUSTOMER][NEUTRAL] Does it cover everything or does he have a, are there any limitations?
[AGENT][NEUTRAL] Uh, there are some outpatient limits. Are they being seen on an outpatient basis?
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] What is the maximum per procedure?
[AGENT][NEUTRAL] Their outpatient benefit max is for a calendar year which is 2500.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] And have they accumulated anything?
[AGENT][NEGATIVE] Looks like they have not used anything as of to date.
[CUSTOMER][NEUTRAL] OK, so this would be considered for outpatient, so maximum is 2500.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] All right, perfect. And um all right, excellent. Can you spell your name and the initial of your last name please?
[AGENT][NEUTRAL] Yeah, absolutely. My name is [PII], that's [PII].
[AGENT][NEUTRAL] And then today's date is the call reference.
[CUSTOMER][POSITIVE] All right, perfect, excellent thank you so much for your time I really do appreciate it.
[AGENT][POSITIVE] My pleasure. Have a good day, [PII].
[CUSTOMER][NEUTRAL] Have a
[CUSTOMER][NEUTRAL] You as well bye bye.
[AGENT][NEUTRAL] OK.