AccountId: 011433970860
ContactId: 5c8ecf7a-cd7c-4e1b-945e-0ea1a49e3be0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 157720 ms
Total Talk Time (AGENT): 67993 ms
Total Talk Time (CUSTOMER): 56963 ms
Interruptions: 0
Overall Sentiment: AGENT=3.6, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/5c8ecf7a-cd7c-4e1b-945e-0ea1a49e3be0_20250505T17:29_UTC.wav
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[AGENT][POSITIVE] Oh thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, I was calling to verify eligibility for a member.
[AGENT][POSITIVE] Sure, I can assist you with that. Can I have your name and the call back number?
[CUSTOMER][NEUTRAL] Yes, my name is [PII], that is [PII] Last name [PII] [PII], and callback number is [PII].
[CUSTOMER][NEUTRAL] [PII] and that's a direct line.
[AGENT][POSITIVE] Thank you, [PII].
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] What is the policy number of the member that you're calling to verify benefits for today?
[CUSTOMER][NEUTRAL] It is 01997051.
[AGENT][NEUTRAL] Thank you, [PII]. Could you verify that patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII] with the date of birth of [PII].
[AGENT][NEUTRAL] And you're calling to verify benefits eligibility for what place of service.
[CUSTOMER][NEUTRAL] This is for an office visit.
[AGENT][NEUTRAL] You can check the status of a claim or verify benefits.
[CUSTOMER][NEUTRAL] Just verify benefits.
[AGENT][NEUTRAL] OK, so this member's policy has been active since [PII] and it's currently active, and unfortunately [PII], office visits are not covered under the policy. However, the member does have outpatient benefits which the treatment received in the office, so any procedure that's performed in the office is covered under the outpatient benefits of $7000 per calendar year, and this is not a guaranteed benefits, just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] OK. So that basically just covers uh procedures done in the office?
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, thank you for verifying. Was there a call reference number?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] We don't provide those, however, you can use my name in today's date as a reference is [PII], and today's date.
[CUSTOMER][POSITIVE] Thank you so much again for your help.
[AGENT][POSITIVE] You're welcome. Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] No, ma'am.
[AGENT][POSITIVE] Thanks for calling APL and have a great day, [PII].
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thanks, goodbye.