AccountId: 011433970860
ContactId: 4beb7e80-74d2-4f49-82fc-ee5bd14c0b7b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 265250 ms
Total Talk Time (AGENT): 90143 ms
Total Talk Time (CUSTOMER): 127625 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/11/4beb7e80-74d2-4f49-82fc-ee5bd14c0b7b_20250311T15:36_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], good, um, is it morning still? Good morning or, or, or early afternoon? OK, so I need to speak to somebody about patients eligibility and benefits.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, I can help you.
[CUSTOMER][POSITIVE] OK great
[AGENT][POSITIVE] I can help you with both the eligibility and the benefits. May I have your name and a good contact number?
[CUSTOMER][NEUTRAL] Yes, it's [PII] spelled [PII], first initial to my last name is [PII]
[AGENT][NEUTRAL] Thank you. And may I have a good contact number in case we're disconnected and then the policy number?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] And then um patients ID number is [PII].
[CUSTOMER][NEUTRAL] 89 then it looks like it's [PII].
[AGENT][NEUTRAL] Thank you. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes, she's [PII]. Date of birth is [PII].
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So I am showing the policy is active. It's been effective since [PII].
[AGENT][NEUTRAL] And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, so this patient is coming in for a follow up and I need to know if there's any.
[CUSTOMER][NEUTRAL] Copays or any deductibles like out of pockets that need to be met, uh, she does have a primary insurance.
[AGENT][NEUTRAL] Follow up as in like a follow-up office visit appointment or like a follow-up surgery or?
[CUSTOMER][NEUTRAL] No, it's like a follow up office appointment.
[AGENT][NEUTRAL] OK, so we pay towards the copay, the deductible and co-insurance of covered charges after primary. So we don't apply a co-pay, we help pay it. Um, the benefit is up to $500 per calendar day.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the the the policy itself doesn't have any like in-office coverage, but they do have the office treatment rider. So any treatment or most treatment done in the office as long as it's not cosmetic, could be covered up to that $500 per day.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK perfect so she has an active policy and 500 daily for specialty office treatment. Effective date is [PII].
[CUSTOMER][NEUTRAL] And this is a secondary plan correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me put here.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK great and can I please get a reference number for the information?
[AGENT][NEUTRAL] Sure, sir, there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] What's the spelling of your name?
[AGENT][NEUTRAL] My first name is [PII]
[CUSTOMER][NEUTRAL] [PII] OK.
[CUSTOMER][POSITIVE] And then the first initial I'm sorry.
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, today's date right.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] [PII] OK perfect thank you and uh you have a wonderful rest of the day.
[AGENT][POSITIVE] You're very welcome. Was there anything else I could assist you with today?
[CUSTOMER][POSITIVE] No, that'll be it thank you so much have a great day bye bye.
[AGENT][POSITIVE] You also thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.