AccountId: 011433970860
ContactId: 6d349305-a870-4f76-801b-196a8bcce96b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 163580 ms
Total Talk Time (AGENT): 89190 ms
Total Talk Time (CUSTOMER): 53664 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/6d349305-a870-4f76-801b-196a8bcce96b_20250403T13:46_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] So what if I
[CUSTOMER][NEUTRAL] Yes, hi. I just needed to verify eligibility for a patient, please.
[AGENT][POSITIVE] Sure, I can assist you with that.
[AGENT][NEUTRAL] Can I have your name and a callback number?
[CUSTOMER][NEUTRAL] Yes, my name is [PII] last initial [PII]
[CUSTOMER][NEUTRAL] The number is [PII].
[AGENT][NEUTRAL] Thank you [PII], and what is the member's policy number that you're calling to verify eligibility for?
[CUSTOMER][NEUTRAL] It is 023 04303, M as in Mary, L as in Larry, 8.
[AGENT][NEUTRAL] Thank you and could you verify that patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're calling to verify eligibility and benefits. [PII] for what place of service?
[CUSTOMER][NEUTRAL] Um, it's for specialist, um, medical.
[AGENT][NEUTRAL] Specialist office visit?
[CUSTOMER][NEUTRAL] Yes. Mhm.
[AGENT][NEUTRAL] So the office visit itself is not covered under the policy, however, the visit, the procedures that's taking place in the office.
[AGENT][NEUTRAL] They are covered and they fall under her outpatient benefits.
[AGENT][NEUTRAL] And her outpatient benefits are?
[AGENT][NEUTRAL] $7500 per calendar year and this is not a guaranteed benefits just a disclaimer of the policy's coverage.
[AGENT][NEUTRAL] And this policy has been active since [PII].
[CUSTOMER][NEUTRAL] Only procedures.
[AGENT][NEUTRAL] Do you understand what I just said? A lot of callers when I tell them that the office visit itself is not covered, but the treatment received in the office is, they be like, what do you mean? And I'd be like, well, you know, say if a patient comes in for a broken arm and the treatment, they have to perform to help with the broken arm is covered, but the visit itself is not covered. But you understood.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Which, yeah, it's it's unusual, um, but yes, I do understand it.
[CUSTOMER][NEUTRAL] OK, do you have a reference number for the call, please?
[AGENT][NEUTRAL] We don't provide those unfortunately [PII], however, you can use my name and today's date as a reference.
[CUSTOMER][NEUTRAL] OK, and what was your name again?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] In today's date.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][POSITIVE] Alright perfect thank you so much you have a good day.
[AGENT][POSITIVE] Thanks and you do the same as well [PII]. Thanks for calling APL Goodbye.
[CUSTOMER][POSITIVE] Thank you bye bye.