AccountId: 011433970860
ContactId: 5577cd9f-a6b0-4228-a839-e8d77206b38d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 200990 ms
Total Talk Time (AGENT): 57007 ms
Total Talk Time (CUSTOMER): 87366 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/18/5577cd9f-a6b0-4228-a839-e8d77206b38d_20250318T13:03_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I have two quick questions to ask about a patient's benefits.
[AGENT][POSITIVE] Sure, can. I can assist you with that.
[AGENT][NEUTRAL] I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] Yes, callback number is [PII], and then the policy number is 01777823.
[AGENT][NEUTRAL] Could you verify that patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] And you said you had a question in regards to the member's policy, is are you calling to verify benefits and eligibility or a question in regards to a claim?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] No question um in regards to benefits.
[AGENT][NEUTRAL] OK. So would you like for me to verify the benefits?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm well I had questions to ask.
[AGENT][NEUTRAL] Remember?
[CUSTOMER][NEUTRAL] I just wanted to find out how much they've used from the yearly max. Have they made their deductible and would they be eligible for a pro exam by wings and FMX or panel? Those are my questions.
[AGENT][NEUTRAL] Verify his date of birth again if you don't mind.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] They've utilized, they have $1,149.20 left remaining with a $50 deductible being met.
[AGENT][NEUTRAL] And what were the proceed what's your first procedure called?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] No history on file. What's your next one?
[CUSTOMER][NEUTRAL] 0120.
[AGENT][NEGATIVE] No history on file.
[CUSTOMER][NEUTRAL] 0274.
[AGENT][NEGATIVE] No history on file.
[CUSTOMER][NEUTRAL] Um, then 0210.
[AGENT][NEUTRAL] This was completed [PII].
[CUSTOMER][NEGATIVE] Alright, so they're not eligible for that. OK, not eligible for FMX.
[CUSTOMER][NEUTRAL] Alright, so just to read, we said this patient is still active with 1,149 and 20 cents remaining from the yearly max. The deductible has been met and this patient is only eligible for a profi exam in bye wings and not eligible for a for an SMX or panel.
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][POSITIVE] OK perfect thank you so much. Can I have the reference number for this call?
[AGENT][NEUTRAL] Is there anything else that I can assist you with, [PII]? We don't provide those.
[AGENT][NEUTRAL] You can use my name in today's date.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][POSITIVE] Alright, got it, um, alrighty, thank you so much. That would be all enjoy the rest of your day.
[AGENT][POSITIVE] Thanks for calling [PII] you have a great one as well. Bye bye.