AccountId: 011433970860
ContactId: 61a2c9a0-88af-46a5-89d4-c5d97302b9e4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 144619 ms
Total Talk Time (AGENT): 68555 ms
Total Talk Time (CUSTOMER): 55001 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=3.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/61a2c9a0-88af-46a5-89d4-c5d97302b9e4_20250407T18:17_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good afternoon. My name is [PII]. First initial of my last name [PII]. I'm calling from a provider facility because I need to verify benefits for a member, please.
[AGENT][POSITIVE] I'm sure [PII] I can assist you with benefits. Um, first, I'll need a good callback number just in case we're disconnected.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] It's 01611708, M as in Mike, L as in Lima, and the number 8.
[AGENT][NEUTRAL] OK, thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] His name is [PII] and date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you and just let me advise you that verification of coverage does not guarantee payment of claims.
[AGENT][NEUTRAL] Um, I'm showing the effective date on this policy was [PII]. The policy is still active. And is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Outpatient benefits.
[AGENT][NEUTRAL] OK, for outpatient, we cover up to 1500 per calendar year and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim.
[CUSTOMER][POSITIVE] Perfect. And are you able to see if the member has used any of those 1500?
[AGENT][NEUTRAL] Um, yeah, so far he has used $176.58.
[CUSTOMER][POSITIVE] OK. OK, perfect. Thank you so much. I believe that's all I needed to know. Um, uh, could I have the first letter of your last name and a call reference number?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date, and the first letter of my last name is [PII]. Um, is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] That would be all. Thank you so much.
[AGENT][POSITIVE] OK, thank you again, [PII] for calling APL. You have a great rest of your day. Mm bye.
[CUSTOMER][POSITIVE] Thank you you as well bye bye.