AccountId: 011433970860
ContactId: 6dfcb9e2-daa9-4132-a583-bb695ffc70d5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 137559 ms
Total Talk Time (AGENT): 70008 ms
Total Talk Time (CUSTOMER): 45580 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/01/6dfcb9e2-daa9-4132-a583-bb695ffc70d5_20250501T16:45_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I just need to verify um.
[CUSTOMER][NEUTRAL] Uh, members eligibility and benefits.
[AGENT][NEUTRAL] OK, I can verify eligibility and benefits for you, Ms. [PII], and what's that policy number, please?
[CUSTOMER][NEUTRAL] Um 01902342.
[AGENT][POSITIVE] OK, thank you so much. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yes, I do [PII] is my direct line.
[AGENT][NEUTRAL] OK, thank you, Ms [PII] and verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, thank you. And you say you're calling for eligibility and benefits, correct?
[CUSTOMER][NEUTRAL] Yep.
[AGENT][NEUTRAL] OK, I'm showing her effective date is [PII]. She is active under the policy and what benefits are needing for this patient?
[CUSTOMER][NEUTRAL] Um, for an abdomen ultrasound.
[AGENT][NEUTRAL] OK, and is this gonna be done in uh performed in an outpatient facility or inpatient?
[CUSTOMER][NEUTRAL] Uh, yes, outpatient.
[AGENT][NEUTRAL] OK, uh, not a guarantee of payment, just a verification of coverage. But this policy is secondary, we help with primary insurance deductible, co-pay, and or co-insurance, and she has an outpatient benefit max of up to $1000 per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um, and then does she need prior authorization then a secondary?
[AGENT][NEUTRAL] No, ma'am, prior authorization is not required.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect thank you and then um could I get your name and a reference number for our call?
[AGENT][NEUTRAL] Sure. Uh my name is [PII], and for a reference number you can use my name in today's date if you like.
[CUSTOMER][NEUTRAL] OK, and then could you tell me one more time what the um name of your entity is?
[AGENT][NEUTRAL] American Public Life or APL.
[CUSTOMER][POSITIVE] American Public Life. OK, perfect. Thank you so much for your help.
[AGENT][POSITIVE] Oh, yes, ma'am. Thank you for calling APL. You have a great day, Ms. [PII].
[CUSTOMER][NEUTRAL] You too bye bye.