AccountId: 011433970860
ContactId: 6ff2d558-a2c2-45b0-86e0-176c86b63621
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 197660 ms
Total Talk Time (AGENT): 91409 ms
Total Talk Time (CUSTOMER): 45990 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/6ff2d558-a2c2-45b0-86e0-176c86b63621_20250421T20:55_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, uh, this is [PII] from Doctor [PII]'s office calling to, uh, for one of our patients trying to see what they're eligible for in a co-pay.
[AGENT][NEUTRAL] I'm sorry, it is very quiet um we're checking eligibility, is that right?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, I could check that for you. um, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and do you have that policy number?
[CUSTOMER][NEUTRAL] Yes ma'am, 025758778.
[AGENT][NEUTRAL] I'm sorry, uh, what were the last two digits?
[CUSTOMER][NEUTRAL] 78
[AGENT][NEUTRAL] 78
[AGENT][NEUTRAL] And what was the name and date of birth for the member?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Do you have that date of birth?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. Uh, so this policy is active. Effective date was [PII].
[CUSTOMER][NEUTRAL] OK, OK, we're trying to see what is covered.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] And his benefits, the benefits.
[AGENT][NEGATIVE] I'm very sorry. It uh sounds very quiet. I'm having a hard time hearing you.
[CUSTOMER][NEUTRAL] His benefits.
[AGENT][NEUTRAL] You need to go over benefits.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, um, what kind of benefits, what were, uh, what was he gonna be seen for?
[CUSTOMER][NEUTRAL] Office visit
[AGENT][NEUTRAL] Office visit, OK, um, let's see, so I will say this is a limited indemnity medical plan, uh, so it pays a set dollar amount per covered procedure or office visit. Um, let me see if that's something that's going to be covered under this policy. Was this uh visit regarding, um, an accident or, or excuse me, an injury or a sickness, or was this like a wellness kind of benefit or wellness exam?
[CUSTOMER][POSITIVE] Pretty sure wellness.
[AGENT][NEUTRAL] Well, OK, one moment.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Appreciate your patience. Uh, so this policy does not offer any benefits for uh office visits.
[CUSTOMER][NEUTRAL] OK, alright, thank you. So it's a hos OK, it's a group hospital.
[AGENT][POSITIVE] Of course, thank you.
[AGENT][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Yeah, so it's um the only benefits this member has um hospital admission, hospital confinement, intensive care, and rehabilitation. That is the extent of this policy.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Of course thank you have a great day.
[CUSTOMER][NEUTRAL] You too.