AccountId: 011433970860
ContactId: 665d2edc-d352-4da4-b6cf-ce2c906dd397
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 158820 ms
Total Talk Time (AGENT): 75678 ms
Total Talk Time (CUSTOMER): 53311 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/01/665d2edc-d352-4da4-b6cf-ce2c906dd397_20250401T16:40_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] with initial last name. [PII] calling you from our office to check the eligibility and verification one of my patients. Could it be something like that.
[AGENT][NEUTRAL] Yeah, I can check eligibility for you. Uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure. That is [PII]. It's a direct line. There is no.
[AGENT][NEUTRAL] OK, thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Yes. Uh, I have the policy number. That is 01792121.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] Name of this member is [PII] and the date of birth is [PII].
[AGENT][POSITIVE] Perfect. Thank you for verifying that, [PII]. So this policy is active. Effective date was [PII], and this is a secondary medical policy. So it is designed to help with co-pay, deductible and co-insurance after major medical pays.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And may I know the annual maximum benefits for this?
[AGENT][NEUTRAL] Could you repeat that? I'm sorry.
[CUSTOMER][NEUTRAL] May I know the annual maximum benefits?
[AGENT][NEUTRAL] Of course, uh, of course I will let you know verification of coverage is not a guarantee of payment for claims.
[AGENT][NEUTRAL] So their inpatient benefit and their outpatient benefit are both $5000 max per calendar year and if you'll give me one moment I'll see if any of that has been used.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so [PII] has used $13.70 of that, uh, outpatient benefit so far this year.
[CUSTOMER][NEUTRAL] 1317, right? 13.17.
[AGENT][NEUTRAL] 13.70.
[CUSTOMER][NEUTRAL] OK, OK, got it.
[CUSTOMER][NEUTRAL] And uh could you please spell out your name with initial last name?
[AGENT][NEUTRAL] Yes, uh it's [PII] last initial is [PII] Was there anything else I could help you with, [PII]?
[CUSTOMER][NEUTRAL] Uh, no, [PII]. Do you have any call reference number for this?
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date.
[CUSTOMER][POSITIVE] OK. Thank you so much, [PII], for all the information that you have provided to me. I have a wonderful day.
[AGENT][NEUTRAL] Of course.
[AGENT][POSITIVE] Thanks for calling APL. You too. Bye bye.
[CUSTOMER][NEUTRAL] Bye.