AccountId: 011433970860
ContactId: 492805c1-ade0-49f2-bbee-49af217d4836
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 183860 ms
Total Talk Time (AGENT): 83682 ms
Total Talk Time (CUSTOMER): 82509 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/22/492805c1-ade0-49f2-bbee-49af217d4836_20250422T13:21_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, yes, I'm calling for benefits and eligibility please for one of our patients.
[AGENT][POSITIVE] Sure, I can assist you with that. Can I have your name and a callback number?
[CUSTOMER][NEUTRAL] Of course, it's gonna be [PII]. And my name is [PII] I'm so sorry, you said your name is?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] You said your name was [PII]?
[CUSTOMER][POSITIVE] CA mhm yes, correct.
[AGENT][NEUTRAL] Thank you. Can I have that policy number of the member that you're calling to verify benefits for [PII].
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Of course, 02473906.
[AGENT][NEUTRAL] Can you verify the patient's name and date of birth, and I'll be able to assist you.
[CUSTOMER][NEUTRAL] Yes, um, it's gonna be, I'm gonna spell it out because I'm not sure how to pronounce it. It's gonna be [PII].
[AGENT][NEUTRAL] I don't blame you.
[CUSTOMER][NEUTRAL] [PII], it's [PII] Last name is [PII].
[AGENT][NEUTRAL] Thank you, this policy has been active since [PII] and it's currently active.
[AGENT][NEUTRAL] And you're calling to verify benefits and eligibility for what place of service?
[CUSTOMER][NEUTRAL] For office visit and outpatient surgery, please.
[AGENT][NEUTRAL] Members policy has outpatient benefits of $500 per occurrence, and she has office visit benefits of $25 per visit up to $50 for a specialist, and this is not a guaranteed benefits with 5 visits per calendar year.
[AGENT][NEUTRAL] For business, I'm sorry, per calendar year and this is not a guarantee of benefits just a disclaimer of the policies coverage and what were you about to say?
[CUSTOMER][NEUTRAL] OK, so for
[CUSTOMER][NEUTRAL] Sorry, it's gonna be um for the office visit for specialist office visit, you said it's 25 or 50. I'm so sorry.
[AGENT][NEUTRAL] 50 $50 per visit.
[CUSTOMER][NEUTRAL] 0, 50.
[CUSTOMER][NEUTRAL] And it's 4 visits. How much has been accumulated out of those 4 visits, please?
[AGENT][NEUTRAL] She's utilized one.
[AGENT][NEUTRAL] For [PII].
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] One visit, perfect. And then you said the plan pays up to $500 per occurrence for diagnosis?
[AGENT][POSITIVE] Yes, that is correct. Per diagnosis. Yes, you understand that you're the first person that I've spoken with that understands.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yes, perfect. Um, all righty. Well, thank you so much, [PII]. You have a great rest of your Tuesday and I hope you have a blessed and a great week, OK? Do you have a reference number?
[AGENT][POSITIVE] Oh, you are so sweet. Thank you for
[AGENT][POSITIVE] Thank you for providing me that information and I pray the same for you as well and we don't provide reference numbers, however, you can use my name and today's date and thanks for calling APL and you have a great day.
[CUSTOMER][POSITIVE] You too. Thank you so much. Bye.
[AGENT][NEUTRAL] You