AccountId: 011433970860
ContactId: 5eca5a2f-058d-4321-bd9a-54db45de29d3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 130520 ms
Total Talk Time (AGENT): 63009 ms
Total Talk Time (CUSTOMER): 46041 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/23/5eca5a2f-058d-4321-bd9a-54db45de29d3_20250623T13:54_UTC.wav
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[AGENT][NEUTRAL] Yeah, this is [PII], my sister.
[CUSTOMER][NEUTRAL] Hi [PII], I need benefits eligibility for a patient, please.
[AGENT][POSITIVE] Sure, I can assist you with that. Can I have your name and a callback number?
[CUSTOMER][NEUTRAL] [PII] [PII]
[AGENT][NEUTRAL] You said [PII]. Give me that number again.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] What was the first, the first four digits? I don't know if your phone cutting out or mine.
[CUSTOMER][NEUTRAL] Um, so it's [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And can I have the policy number of the member that you're calling to verify benefits for?
[CUSTOMER][NEUTRAL] 02518216
[AGENT][NEUTRAL] And um you're calling to verify benefits and eligibility for what patient?
[CUSTOMER][NEUTRAL] Um, the patient is [PII].
[AGENT][NEUTRAL] And her date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, and you're calling to verify benefits and eligibility for what place of service, [PII]?
[CUSTOMER][NEUTRAL] Uh, the visit is in offices for a specialist office visit.
[AGENT][NEUTRAL] So office visits are not covered under the policy, however, the treatment received in the office is covered under the policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And she has outpatient benefits of 6000.
[AGENT][NEUTRAL] $75 per calendar year and this is not a guarantee of benefits just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] OK. All right. So the patient is responsible for their co-pay from the primary insurance, right?
[AGENT][NEUTRAL] So, because this is a insurance, this is not a primary insurance, I can't say that I can only verify that we don't cover offices, but the treatment received in the office would fall on the outpatient benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. All right, perfect. That's what I needed. Is there a
[AGENT][NEUTRAL] Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] Do you have a reference number for me?
[AGENT][NEUTRAL] We don't provide reference numbers, but you can use my name in today's date as a reference.
[CUSTOMER][POSITIVE] OK, thank you so much for your help.
[AGENT][POSITIVE] Thanks for calling APL. You have a great one. Goodbye.
[CUSTOMER][NEUTRAL] You too bye bye.