AccountId: 011433970860
ContactId: 6ab184b6-9d37-4033-a1a4-9dd122a56e04
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 159110 ms
Total Talk Time (AGENT): 84360 ms
Total Talk Time (CUSTOMER): 46019 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/6ab184b6-9d37-4033-a1a4-9dd122a56e04_20250428T15:26_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm calling for eligibility and benefits for patients.
[AGENT][NEUTRAL] OK, may I have your name?
[CUSTOMER][NEUTRAL] [PII]?
[AGENT][POSITIVE] Thank you [PII] and your call back number please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you so much and may I have the policy number please?
[CUSTOMER][NEUTRAL] It is 01868783.
[AGENT][NEUTRAL] OK, let me just repeat that to you. I have that as 01868783.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, thank you. Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, thank you very much for the information. Now you're calling for eligibility and benefits, would that be for inpatient or outpatient today?
[CUSTOMER][NEUTRAL] It's a specialist office visit.
[AGENT][NEUTRAL] OK, so outpatient benefits, OK, um.
[CUSTOMER][POSITIVE] So outpatient mhm.
[AGENT][NEUTRAL] OK, thank you. Uh, her policy shows effective as of [PII] and it shows that it is currently active. Let me check for benefits for an office visit please, specialist.
[AGENT][NEGATIVE] And my apologies, this plan does not cover for an office visit.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] That's what I was needing to know if it covered.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Because she does have a different another insurance she has Blue Cross Blue Shield as primary.
[AGENT][NEUTRAL] Yes, and we are her secondary or supplemental.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, so it doesn't, so it doesn't cover the copayment or anything like that?
[AGENT][NEUTRAL] It does not cover the copay for the office visit. Now if she has any um a procedure or service performed inside the doctor's office that could be covered up the outpatient max. So let me get that information to you as far as outpatient max is concerned. Um, please note verification of benefits provided does not guarantee payment. We pay up to $2550 for the calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Alright and who am I speaking with?
[AGENT][NEUTRAL] My name is [PII]. My last initial is [PII].
[CUSTOMER][NEUTRAL] And a reference number for today's call?
[AGENT][NEUTRAL] We did not use reference numbers on [PII] you can use my name in today's date.
[CUSTOMER][NEUTRAL] No, OK.
[CUSTOMER][POSITIVE] OK, that's fine all right thank you.
[AGENT][POSITIVE] Thank you for calling APL. Take care bye.
[CUSTOMER][NEUTRAL] Mhm.