AccountId: 011433970860
ContactId: 7848e6f1-13be-4452-91ce-00dff58e07ab
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 205940 ms
Total Talk Time (AGENT): 87143 ms
Total Talk Time (CUSTOMER): 66705 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/17/7848e6f1-13be-4452-91ce-00dff58e07ab_20250217T15:29_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hello, good morning. My name is [PII] calling from Capital Sleep Medicine. I would like to verify a patient's eligibility and medical benefits.
[AGENT][NEUTRAL] OK, I'm sorry, what was your name?
[CUSTOMER][NEUTRAL] My first name is [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And do you have a phone number I can get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] 2173604.
[AGENT][POSITIVE] Thank you, [PII]. Hold on one moment, please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you, [PII], you were just needing benefits.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK. I can help you with that. Is it for outpatient, inpatient, or doctor's office?
[CUSTOMER][NEUTRAL] Uh, for, uh, outpatient and doctor's office.
[AGENT][NEUTRAL] OK, any benefits given over the phone is not a guarantee of payment. The effective date is [PII].
[AGENT][NEUTRAL] This policy coordinates with the primary insurance. Whatever the primary applies to their deductible, co-pay or co-insurance for outpatient, we'll pay up to $5750.
[AGENT][NEUTRAL] Office visits are not covered under this policy.
[AGENT][NEUTRAL] But if they have any services done in the doctor's office, it will be covered under that outpatient benefit as well.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Just the office visit itself is not covered.
[CUSTOMER][NEUTRAL] And you said that he has a 5700 maximum benefit and uh there's still remaining for there or any accumulations for that.
[AGENT][NEUTRAL] $5750 and let me see what is left.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] They have not used anything.
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][POSITIVE] All right, thank you so much for that information. Um, can I have your first name again please? And if there is a call reference number?
[AGENT][NEUTRAL] We do not have call reference numbers. You can use my name and today's date. That is [PII]
[AGENT][NEUTRAL] The first initial to my last name is [PII]
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Alright, got it. Thank you so much, [PII], for your assistance.
[AGENT][POSITIVE] Thank you, [PII], for calling APL. You have a good day.
[CUSTOMER][NEUTRAL] Hey, you too. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.