AccountId: 011433970860
ContactId: 5795e8f6-1a7c-4450-b69f-555989b68117
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 191679 ms
Total Talk Time (AGENT): 64156 ms
Total Talk Time (CUSTOMER): 99769 ms
Interruptions: 3
Overall Sentiment: AGENT=0.6, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/05/5795e8f6-1a7c-4450-b69f-555989b68117_20250205T14:06_UTC.wav
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[AGENT][NEUTRAL] [PII], this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, ma'am. I was trying to verify benefits for a member.
[AGENT][POSITIVE] OK, I can help you with your name.
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] [PII], OK.
[AGENT][NEUTRAL] And is this for service in a doctor's office?
[CUSTOMER][NEUTRAL] I'm sorry, what did you say?
[AGENT][NEUTRAL] Is this for service in a doctor's office?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, the policy number?
[CUSTOMER][NEUTRAL] It is 02580694.
[AGENT][NEUTRAL] OK phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Um, you call [PII].
[AGENT][NEUTRAL] OK, thank you. What's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] [PII], what's her date of birth?
[CUSTOMER][NEUTRAL] Give me 1 2nd.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thanks for that information, [PII]. The policy effective date is [PII].
[AGENT][NEUTRAL] [PII] policy is active at this time, and the maximum, let's see.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Do you know the in your card.
[AGENT][NEUTRAL] Um, so the only benefit for service in this office is if it's uh some type of a surgical procedure. Otherwise, there's no benefit.
[CUSTOMER][NEUTRAL] OK, so it's only surgical benefits. No, like if she's coming into, so we are promptcare. She's coming to like we promptcare slash urgent care, so she don't have any benefits for this type of service.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] No, she doesn't.
[CUSTOMER][NEUTRAL] OK, so, all right, um, hold for me while I let this member know it.
[CUSTOMER][NEUTRAL] Um, hold for me. Would you like to, OK, OK, OK, because I told her we are prompt care, she said you only have surgical. No, I have, I have it all. OK, alright, um, thank you for speaking with me because she says she has some medical as well, but I'm not for sure what's going on right now but thank you, but.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, it is a, it is a medical, it's a medical policy. There's a hospital admission benefit, which that doesn't apply. Uh, the policy says an accident or sickness surgeries benefit. So it's if, if it's if she has a, like a surgery or something in a physician's office. Otherwise, there's, there's no coverage.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, wait a minute, OK.
[CUSTOMER][NEUTRAL] Yeah, I think you need to hear what she's saying because if you're paying for it, I wanna make sure you're paying for the right thing that you think you're paying for because what she's telling me none of that is covered. OK, OK, well thank you for speaking with me.
[AGENT][NEUTRAL] All right, [PII], anything else I could help out with today?
[CUSTOMER][NEUTRAL] No, ma'am, that was all. bye bye.
[AGENT][POSITIVE] OK, thanks for calling APL have a good day.
[CUSTOMER][NEUTRAL] Yeah, yeah.