AccountId: 011433970860
ContactId: 54fe90e6-fac1-4358-98b3-098d023c5d92
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 194940 ms
Total Talk Time (AGENT): 78828 ms
Total Talk Time (CUSTOMER): 67179 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/07/54fe90e6-fac1-4358-98b3-098d023c5d92_20250307T16:21_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]. Good day. My name is [PII]. I'm calling in regards to check for uh benefits and eligibility for a member.
[AGENT][POSITIVE] Sure, I can check eligibility and benefits for you. Um, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, that's [PII].
[AGENT][NEUTRAL] OK, thank you and then do you have that policy number?
[CUSTOMER][NEUTRAL] Yes ma'am, just one second.
[AGENT][NEUTRAL] OK. Mhm.
[CUSTOMER][NEUTRAL] So the ID number is 02317301 M as in Mary, L as in Lima, 8.
[AGENT][NEUTRAL] OK. And uh what was the name and date of birth for the patient, please?
[CUSTOMER][NEUTRAL] Name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that, [PII]. So this policy is active. Effective date was [PII], 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 we needing to check the inpatient or the outpatient benefits?
[CUSTOMER][NEUTRAL] For the outpatient.
[AGENT][NEUTRAL] Outpatient, OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims, so their outpatient benefit is on a per calendar day basis. It pays up to $500 max per calendar day.
[CUSTOMER][NEUTRAL] Up to $500.
[AGENT][NEUTRAL] Yes, per day.
[CUSTOMER][NEUTRAL] Per day.
[CUSTOMER][NEUTRAL] Ha
[CUSTOMER][NEUTRAL] And may I confirm if the office visit is covered?
[AGENT][NEUTRAL] OK, so office visits under this policy are not going to be covered. However, treatment received in office uh is.
[CUSTOMER][POSITIVE] Mm, OK. I see. Thank you for that information. So.
[CUSTOMER][NEUTRAL] And may I ask what is the um plan type?
[AGENT][NEUTRAL] It's a secondary medical policy.
[CUSTOMER][POSITIVE] All right, thank you, that's all I need to confirm, ma'am. Thank you so much for your help and by the way, can I get your last name initial, and a reference number for this call?
[AGENT][NEUTRAL] Sure, reference number would just be my first name, last initial, and today's date. Uh, so my name is spelled [PII] Was there anything else I can help you with, [PII]?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] No, that'll be all. Thank you so much and have a great day.
[AGENT][POSITIVE] Alright, of course, thanks for calling APL you too bye bye.
[CUSTOMER][POSITIVE] Thanks bye.