AccountId: 011433970860
ContactId: 5779724e-f0ab-4e00-8e62-66768f5f2253
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 155279 ms
Total Talk Time (AGENT): 74610 ms
Total Talk Time (CUSTOMER): 49329 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/5779724e-f0ab-4e00-8e62-66768f5f2253_20250130T16:36_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thank you for calling APL this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm calling from Pama Health, and I want to verify patients benefits eligibility.
[AGENT][NEUTRAL] OK ma'am, can I get a good call back number?
[CUSTOMER][NEUTRAL] [PII]. No extension.
[AGENT][NEUTRAL] OK, thank you, ma'am. Can I get the policy number?
[CUSTOMER][NEUTRAL] Yes. Yes.
[CUSTOMER][NEUTRAL] 01687790
[AGENT][NEUTRAL] 016. Repeat that for me please.
[CUSTOMER][NEUTRAL] 01687790
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Can you confirm the patient's name and date of birth for me, ma'am?
[CUSTOMER][NEUTRAL] [PII]. Date of birth, [PII].
[AGENT][NEUTRAL] OK, thank you and you said you're calling to confirm eligibility, is that correct?
[CUSTOMER][POSITIVE] And benefits.
[AGENT][NEUTRAL] OK, I can definitely take a look. It looks like they were effective with this [PII] and currently still active.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Will this be for a certain place of service?
[CUSTOMER][NEUTRAL] Uh, it's a sick office visit for primary and specialist?
[AGENT][NEUTRAL] OK, so this will be a verification of benefits and not a guarantee of payment. Bear with me here while the policy is loading.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] So on this policy, um, the benefits.
[AGENT][NEUTRAL] They have, it is an outpatient sickness rider, so the policy will pay 5 visits per calendar year and the policy pays $75 per visit, with a maximum of 10 visits combined.
[AGENT][NEUTRAL] On the policy.
[CUSTOMER][NEUTRAL] OK $5.
[CUSTOMER][NEUTRAL] And how many visits remaining for this year? I mean just beginning we just want to make sure.
[AGENT][NEUTRAL] Um, for the claims that we have processed, they haven't used any visits, but that does not include any outstanding claims that we haven't processed.
[CUSTOMER][NEUTRAL] OK. So, uh, uh, this plan pays $75 per visit and in uh 5 visits per year, right?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, I just need your name and the call reference number please.
[AGENT][NEUTRAL] The call reference number will be my name, so it's [PII] with the first initial to my last name [PII], and today's date. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, thank you so much.
[AGENT][POSITIVE] OK, well thank you for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] Thank you too.