AccountId: 011433970860
ContactId: 64b56256-6d8e-444c-accf-8dcdb64beb4a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 623239 ms
Total Talk Time (AGENT): 165501 ms
Total Talk Time (CUSTOMER): 145009 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/21/64b56256-6d8e-444c-accf-8dcdb64beb4a_20250521T17:52_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I have a patient of ours here that just wants to look up her um benefits and copays.
[AGENT][NEUTRAL] OK, you're needing to verify a member's eligibility, is that correct?
[CUSTOMER][NEUTRAL] Exactly. Mhm.
[AGENT][NEUTRAL] Do you also need benefit information or just the eligibility?
[CUSTOMER][POSITIVE] Um, benefit as well.
[AGENT][POSITIVE] Yes, ma'am, I can help you with both. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] Sure, this is [PII]
[AGENT][NEUTRAL] OK, and pronounce it for me one more time, please.
[CUSTOMER][NEUTRAL] Sure, it's 0.
[AGENT][NEUTRAL] Feral
[CUSTOMER][POSITIVE] Yep, that sounds good.
[AGENT][NEUTRAL] Is that close enough? OK, so, thank you. And what is the, and what is a good callback number for you, please?
[CUSTOMER][POSITIVE] Yes, close enough.
[CUSTOMER][NEUTRAL] Sure, I'll give you our office number.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That would be [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And what is the member's policy number, Cyril?
[CUSTOMER][POSITIVE] Sure, let me get that for you.
[CUSTOMER][NEUTRAL] OK, it would be 026.
[CUSTOMER][NEUTRAL] 06666.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Hi, how can I help you?
[AGENT][NEUTRAL] Alright, just one moment please.
[CUSTOMER][NEUTRAL] Sure. Sure, not a problem. Is he a patient enterprise?
[CUSTOMER][NEUTRAL] Not a problem. OK, sure, let me just get him in. Just hold on one second please.
[AGENT][NEUTRAL] OK, and any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Sure, her first name is [PII], last name [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And her date of birth would be [PII].
[AGENT][NEUTRAL] OK, thank you. Uh, it's gonna take me just a moment because I've got to verify something on this policy, please.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK, so who in your family has been here?
[CUSTOMER][NEUTRAL] Just linking together? OK, what's the name?
[CUSTOMER][NEUTRAL] What would you like to add?
[CUSTOMER][NEUTRAL] OK great and what is the date of birth?
[AGENT][POSITIVE] And thank you for your patience, sir. I'm sorry that I'm having to make you wait.
[CUSTOMER][POSITIVE] That's OK. Don't worry about it.
[CUSTOMER][NEUTRAL] OK, great, is his insurance the same as yours?
[CUSTOMER][NEUTRAL] OK, so one works best?
[CUSTOMER][NEUTRAL] Not a problem. Would you like next week Wednesday at [PII] or [PII]?
[CUSTOMER][NEUTRAL] For
[CUSTOMER][NEUTRAL] So I have either a [PII], [PII], or [PII] for next week Wednesday.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK great, amazing.
[CUSTOMER][POSITIVE] OK perfect so you're all set OK.
[AGENT][POSITIVE] Um, goodness gracious. Hold on. [PII], I'm so sorry. I am just, let me try this again.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] That's OK, don't worry about it.
[AGENT][NEUTRAL] I just ask someone that
[AGENT][NEUTRAL] Something
[CUSTOMER][NEUTRAL] I know
[AGENT][NEUTRAL] Again, sir, I can't thank you enough for your patience. Again, I'm having to verify some information on this member before I can confirm her eligibility or benefits with you.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Hi, how can I help you?
[CUSTOMER][NEUTRAL] For sure, not a problem, just hold on one second please, OK?
[AGENT][POSITIVE] OK, [PII]. So thank you so much, so much again for your patience. So, yes, ma'am, I do show that she is the subscriber on this limited benefit plan and it is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] It's my
[AGENT][NEUTRAL] And again, what type of benefit information do you need for her? Is this for an office visit, you said?
[CUSTOMER][NEUTRAL] Mhm, it'd be for a specialist office visit.
[AGENT][NEUTRAL] OK, so one moment.
[CUSTOMER][NEUTRAL] OK, sure, so what works best for you?
[CUSTOMER][NEUTRAL] Is there a time of day that works best for you?
[CUSTOMER][NEUTRAL] Yes, is there a time of day that works best for you, morning or afternoon?
[CUSTOMER][POSITIVE] You like the morning. OK, perfect. Would you like next week Thursday at [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so on this policy, the benefit for a physician's office visit is $100 per day.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And a maximum of 3 days per calendar year per covered person.
[CUSTOMER][NEUTRAL] You do the same.
[CUSTOMER][NEUTRAL] OK, do you have, do you know about a specialist office visit [PII]?
[AGENT][NEUTRAL] There's no difference on this. It's the same.
[CUSTOMER][NEUTRAL] OK, so you said $100 per day.
[AGENT][NEUTRAL] Uh-huh, and a maximum of 3 days per calendar year per covered person.
[AGENT][NEGATIVE] And as of now, there have not been any benefits used for this calendar year.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then also once the claim has been submitted and processed, so we do have a portal in which you should be able to check claim status and the website for our portal is located at [PII].
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] OK. Well, is there anything else that I can help you with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, that'd be it.
[AGENT][POSITIVE] OK, well thank you so much for calling APL. I hope you have a wonderful afternoon and thank you again for your patience.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] My pleasure. Thank you so much for your help.
[AGENT][POSITIVE] Yes ma'am, you're very welcome. Uh huh bye bye.
[CUSTOMER][NEUTRAL] Bye bye.