AccountId: 011433970860
ContactId: 56b629df-8b3f-4863-9eb9-2b0395705ba3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 316820 ms
Total Talk Time (AGENT): 98949 ms
Total Talk Time (CUSTOMER): 111448 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/56b629df-8b3f-4863-9eb9-2b0395705ba3_20250514T12:09_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thank you for calling APL. This is Easy. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi [PII]. My name is [PII], and I'm calling from the justive Medicine Associates. I'm calling regarding a patient that is going to have a procedure outpatient, and I need the benefits.
[AGENT][POSITIVE] Um, yes, ma'am. I can assist you with benefits. Um, first, could I get your name again and a good callback number?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now, could I get the policy number, please?
[CUSTOMER][NEUTRAL] Yes, it's 07931049 M as in Mary, L as in Larry 7.
[AGENT][NEUTRAL] OK. Please repeat that policy number.
[CUSTOMER][NEUTRAL] 07931049 M as in Mary, L as in Larry 7.
[AGENT][NEUTRAL] Mm, OK. No one's coming up under that number. I could try to look them up by name and date of birth or if you have the social, I could look them up that way.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, let me check my social. Hold on.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I got to see.
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] then
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh you.
[CUSTOMER][NEUTRAL] I don't know.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, I'm looking for the social. Let me just.
[CUSTOMER][NEUTRAL] Check if I have it here. If not, I can check, we can check with um.
[CUSTOMER][NEUTRAL] Her name and date of birth.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Yeah, just check with the name and date of birth because the social is not um we don't have it here.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is um her name is [PII].
[AGENT][NEUTRAL] And spell the last name, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And first name [PII]
[CUSTOMER][POSITIVE] [PII], yes.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK, I'm waiting on my system. One moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And what's her date of birth?
[CUSTOMER][NEUTRAL] It's uh [PII].
[AGENT][NEUTRAL] OK, I found her in our system. Would you like her policy number?
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] Um, her policy number is 019.
[AGENT][NEUTRAL] 31049.
[CUSTOMER][NEUTRAL] Please
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. And just let me advise you to verify.
[CUSTOMER][NEUTRAL] No letters at the end?
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII], and the policy is still active. And is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Outpatient, outpatient.
[AGENT][NEUTRAL] OK, for outpatient services, we cover up to 3000 per calendar year and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim.
[CUSTOMER][NEUTRAL] OK perfect and um what's the um um accumulation on that?
[AGENT][NEUTRAL] Um, so far she's used $200 this year.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] Alright, can I get the spelling of your name and a reference number for this call, please?
[AGENT][NEUTRAL] Um, yes, ma'am. The reference number is my name and today's date. Um my name is spelled [PII] and today's date. Um, is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] That's it. Thank you. Have a good day.
[AGENT][POSITIVE] OK, I thank you, [PII] for calling APL. You have a great day as well. Mm bye.
[CUSTOMER][NEUTRAL] Alright, bye bye.