AccountId: 011433970860
ContactId: 7cc143b7-05bb-471a-a2e6-3a2c1cf95109
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 176380 ms
Total Talk Time (AGENT): 74726 ms
Total Talk Time (CUSTOMER): 66918 ms
Interruptions: 2
Overall Sentiment: AGENT=0.6, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/7cc143b7-05bb-471a-a2e6-3a2c1cf95109_20250513T14:15_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Good morning. Uh, my name is [PII]. I'm calling from a specialist office. I'm trying to find out, um, if, uh, this patient's secondary plan covers anything for the primary.
[AGENT][POSITIVE] I'd be happy to assist with benefits and eligibility today [PII] if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what's the policy number?
[CUSTOMER][NEUTRAL] Uh, let me see, is it the outpatient benefit certification?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] 01982107 M like Mary L 8
[AGENT][NEUTRAL] Patient's name and date of birth.
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] Date of birth [PII].
[AGENT][NEUTRAL] Thank you for that information. Please be advised the verification of coverage is not a guarantee of payment. I do show the policy is currently active. Effective date is [PII], and I do show that um he does have benefits for treatment in an office or clinic setting.
[CUSTOMER][NEUTRAL] I was just.
[CUSTOMER][NEUTRAL] This was.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Uh, for any treatment or procedures.
[CUSTOMER][POSITIVE] OK, no worries, thank you.
[AGENT][NEUTRAL] You said it's a specialist office?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so the for treatment and procedures we pay up to the $7900 for the co-pay associated with the physician's charges, it's $50.
[CUSTOMER][NEUTRAL] Like it covers 50 or like they would have to pay 50.
[AGENT][NEUTRAL] No, we pay 50 for and we're up towards the copay, we pay 100% of any treatment and procedures up to that 7900.
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[CUSTOMER][NEUTRAL] Towards the copay.
[CUSTOMER][NEUTRAL] Oh, OK, OK. Like, for example, um, I believe the primary copays 60, so the, the patient only pay 10.
[CUSTOMER][NEUTRAL] I just just to make sure.
[AGENT][NEUTRAL] Yeah, let me make sure it's 50. I'm, I'm sure it's, let me just make sure, let me just make sure.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But I believe it's uh.
[AGENT][NEUTRAL] 15.
[AGENT][NEUTRAL] It's 50.
[CUSTOMER][NEUTRAL] It is for you. Got you. OK, I just.
[AGENT][NEUTRAL] Yeah, so they would pay 10 because we're gonna pay 50.
[CUSTOMER][POSITIVE] Excellent. OK, then, uh, I'll let them know. Uh, can I get your name again and a reference number for the call?
[AGENT][NEUTRAL] Reference is just my name [PII] last initial [PII], and the date and time of the call. Was there anything else I could assist with today?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] No, that was all, thank you very much for your help.
[AGENT][POSITIVE] Thank you for calling APL. You have a good day.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You as well bye bye.
[AGENT][NEUTRAL] Bye.