AccountId: 011433970860
ContactId: 7a33326f-44c5-48f3-9725-f966100efa71
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 194149 ms
Total Talk Time (AGENT): 71967 ms
Total Talk Time (CUSTOMER): 77717 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/20/7a33326f-44c5-48f3-9725-f966100efa71_20250520T13:32_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is speaking. May I help you?
[CUSTOMER][NEUTRAL] it's not the final.
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII]. I'm calling to verify eligibility and outpatient benefits for a member, please.
[AGENT][NEUTRAL] OK, I can verify benefits and eligibility for you, Ms. [PII], and what is that policy number, please?
[CUSTOMER][NEUTRAL] Yes. The policy number is, I have 00, sorry, no, I take that back. It's 022.
[CUSTOMER][NEUTRAL] 4046
[CUSTOMER][NEUTRAL] 7, M as in mother, L as in Lima, 8.
[AGENT][NEUTRAL] OK, thank you and do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Uh, yeah, it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you. And let's see.
[AGENT][NEUTRAL] And Ms. [PII], verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] It's [PII], [PII].
[AGENT][NEUTRAL] OK, thank you. I'm showing her effective date is [PII], and she is active on the policy. And you say you're needing outpatient benefits, is that correct?
[CUSTOMER][NEUTRAL] Yes, if she has, uh, she does have a, a bone density test. So we wanna know if it covers any of the co-pays or.
[CUSTOMER][NEUTRAL] Out of pockets.
[AGENT][NEUTRAL] Is it screening?
[CUSTOMER][NEUTRAL] It doesn't specify if it's screening.
[AGENT][NEUTRAL] OK, um, not a guarantee.
[CUSTOMER][NEUTRAL] I mean, her her main insurance, her main insurance is Neighborhood Health plan with United Healthcare.
[AGENT][NEUTRAL] OK, um, not a guarantee of payment, just verification of coverage. With this policy is secondary, it helps with major medicals, deductible, co-pay, and or co-insurance, and the patient has a benefit max of up to 7900 per calendar year.
[CUSTOMER][NEUTRAL] 0, 7900 per calendar year. I had, she still has funds available?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, give me one moment.
[AGENT][NEUTRAL] Uh, she does. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK. Uh, is there a max per day?
[AGENT][NEUTRAL] No, it's per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, um, I'll go ahead and take your name down, sorry, any reference number, we do provide one.
[AGENT][NEUTRAL] Uh, you can use my name at today's date. And Ms. [PII], is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Yeah, I don't have your name.
[AGENT][NEUTRAL] Uh, it's [PII], last initial [PII]
[CUSTOMER][POSITIVE] All right, thank you so much you have a good one.
[AGENT][POSITIVE] Oh you too thanks for calling APL bye.
[CUSTOMER][NEUTRAL] Yeah.