AccountId: 011433970860
ContactId: 5d5025ec-8275-49b1-a9d6-106ada030852
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 250679 ms
Total Talk Time (AGENT): 72011 ms
Total Talk Time (CUSTOMER): 87568 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/5d5025ec-8275-49b1-a9d6-106ada030852_20250609T19:19_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. My name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Hi, yes, I'm calling for benefits of having sin.
[AGENT][NEUTRAL] Hello?
[CUSTOMER][POSITIVE] Yes, I'm calling for for eligibility and benefits for one of our patients, please.
[AGENT][POSITIVE] I'd be happy to assist with benefits and eligibility. May I have your first name please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] And [PII], if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] 145019
[CUSTOMER][NEUTRAL] Uh, sorry, um, 0, yeah, 0190. M as in Mike, L as in Liam 5.
[AGENT][NEUTRAL] Patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the patient's date of birth?
[CUSTOMER][NEUTRAL] Give me one moment.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you for that information.
[AGENT][NEUTRAL] Now I do show this policy termed on [PII]. It's no longer active.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] OK, and the reference number?
[AGENT][NEUTRAL] Reference is just my name [PII] last initial S as in [PII], and the date and time of the call. Is there anything else I could assist with today?
[CUSTOMER][NEUTRAL] OK. Um,
[CUSTOMER][NEUTRAL] Yes, it
[CUSTOMER][NEUTRAL] If you can check if you can um if this other APL is with you guys.
[CUSTOMER][NEUTRAL] It's the member ID for that one.
[AGENT][NEUTRAL] What's the policy number?
[CUSTOMER][NEUTRAL] Is 6060801.
[AGENT][NEUTRAL] That's our payer ID.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Well, I do have the name and the last name because the patient, I guess, put in the wrong information.
[CUSTOMER][NEUTRAL] But I do have the last name and the first name and the date of birth of the patient if you need that.
[AGENT][NEUTRAL] So it's a different
[AGENT][NEUTRAL] Patient?
[CUSTOMER][NEUTRAL] Yes, it's a different patient.
[AGENT][NEUTRAL] What's the patient's name?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] With the S at the end.
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][POSITIVE] Thank you for that.
[AGENT][NEUTRAL] And are you calling for inpatient or outpatient benefits?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Um, outpatient and office visit, please.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Please be advised the verification of coverage is not a guarantee of payment. I do show the policy is active. Effective date is [PII], and I do show the outpatient benefits will fall under her outpatient calendar year maximum of $8700.
[CUSTOMER][NEUTRAL] And how much has been accumulated?
[AGENT][NEUTRAL] Um, let's see.
[AGENT][NEUTRAL] She's only used $746.31 of that.
[CUSTOMER][NEUTRAL] OK, and does that cover for office visit as well or no?
[AGENT][NEUTRAL] It covers for the treatment and procedures at the visit. It does not include the copay associated with the physician's charges.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I can use your name and today's date as well, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][POSITIVE] Perfect thank you so much, [PII] you have a great rest of your day.
[AGENT][POSITIVE] Thank you for calling APL have a good day.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Right