AccountId: 011433970860
ContactId: 6e3ec836-735f-492a-9a83-dbaa64ad019a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 184949 ms
Total Talk Time (AGENT): 91324 ms
Total Talk Time (CUSTOMER): 82353 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=2.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/6e3ec836-735f-492a-9a83-dbaa64ad019a_20250313T13:39_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, hi, ma'am. My name is [PII]. I'm calling from Texas Digestive specialist. I was calling to verify benefits and eligibility for a patient.
[AGENT][POSITIVE] [PII], it would be my pleasure to assist you with eligibility and benefits. What is the callback number?
[CUSTOMER][NEUTRAL] It'll be [PII] and I am at extension [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] Yes, I have 01868778.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you, [PII], and the patient's name and date of birth, please, ma'am?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] This is for [PII]. Date of birth [PII].
[AGENT][POSITIVE] Alright, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I am showing that [PII]'s policy is active.
[AGENT][NEUTRAL] Effective date is [PII] I'm sorry, [PII]. This is a secondary policy to her primary insurance.
[AGENT][NEUTRAL] And you said you were needing benefits as well, correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] All right. What type of coverage are you needing, [PII]?
[CUSTOMER][NEUTRAL] Um, well, I know normally that this policy usually only covers for like procedure slash surgical benefits. Is that correct?
[AGENT][NEUTRAL] Is it in a doctor's office?
[CUSTOMER][NEUTRAL] Yeah, well, um, I, she's coming for an office visit follow up, but it's standard that we have to call the insurances and all that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Yeah, so in the office, doctor's office, the only thing that is covered is treatments and procedures.
[CUSTOMER][POSITIVE] OK, OK, alrighty.
[AGENT][NEUTRAL] The offices it is not covered.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] You're right.
[CUSTOMER][NEUTRAL] OK, um
[CUSTOMER][POSITIVE] Yes, thank you, thank you for that, um, and what, um, is the amount, um, the the limit and the accumulation if you don't mind.
[AGENT][NEUTRAL] For procedures and treatments in office?
[CUSTOMER][NEUTRAL] Mhm or just in general.
[AGENT][NEUTRAL] So that is under her outpatient coverage of $2550 per calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that is a verification of coverage, not a guarantee of payment.
[CUSTOMER][NEUTRAL] And then has she used any?
[AGENT][NEUTRAL] As of right now she's used $6.63.
[CUSTOMER][POSITIVE] OK, alrighty thank you so much for that and um can I have the spelling of your name? I'm sorry.
[AGENT][NEUTRAL] My name is [PII].
[AGENT][POSITIVE] And it has been a pleasure.
[CUSTOMER][POSITIVE] And what, sorry, I'm so sorry. Yes, please.
[AGENT][NEUTRAL] You need a reference number?
[AGENT][POSITIVE] Her reference number is my name and today's date, and it has been a pleasure to assist you with that eligibility and benefits, [PII]. Anything else I can help you with?
[CUSTOMER][POSITIVE] No, that was it. Thank you so much, [PII]. Have a nice day.
[AGENT][POSITIVE] Thank you for calling APL [PII], have a wonderful day as well. Take care.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][NEUTRAL] Bye-bye.