AccountId: 011433970860
ContactId: 4eb2724d-57d2-4e01-9142-71fc16dd5a98
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 135139 ms
Total Talk Time (AGENT): 79142 ms
Total Talk Time (CUSTOMER): 53283 ms
Interruptions: 1
Overall Sentiment: AGENT=0, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/4eb2724d-57d2-4e01-9142-71fc16dd5a98_20250513T18:43_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], uh, good afternoon. I'm calling from CMS Diagnostic Services. I have a patient coming up. I need to check a benefit eligibility, please.
[AGENT][NEUTRAL] Yeah, I could check eligibility benefits for you. I'm sorry, what did you say your name was?
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] What was your name, please?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] OK, [PII], can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] OK. Thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, it is 02563061 MLA.
[AGENT][NEUTRAL] OK, and what was the name and date of birth for the member, please?
[CUSTOMER][NEUTRAL] [PII] and this person born [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that, [PII]. Uh, so this policy is active. Effective date was [PII].
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] And this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays, and we really need to look at uh inpatient or outpatient benefits for this number.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Outpatient please, outpatient.
[AGENT][NEUTRAL] OK, of course, I will let you know verification of coverage is not a guarantee of payment for claims. Uh, so the outpatient benefit is $8700 max per calendar year, and if you'll give me one moment, I will see if any of that has been used.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEGATIVE] OK, so none of that benefit has been used so far this year.
[CUSTOMER][POSITIVE] That's perfect. That's, yeah, perfect. OK, do you have a call reference for me for this call?
[AGENT][NEUTRAL] Yeah, it would just be my first name, last initial, and today's date. Uh so my name is spelled [PII] And was there anything else I can help you with?
[CUSTOMER][POSITIVE] OK, OK, uh, that'll be all. Thank you very much. Have a wonderful afternoon. Thank you.
[AGENT][POSITIVE] Alright, of course, thanks for calling APL you too bye bye.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah bye bye.