AccountId: 011433970860
ContactId: 7d837aa2-dde1-47f5-9ed3-ffc38218c235
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 217220 ms
Total Talk Time (AGENT): 88202 ms
Total Talk Time (CUSTOMER): 78024 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/7d837aa2-dde1-47f5-9ed3-ffc38218c235_20250312T20:49_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hello, my name is [PII]. You said it's [PII], right?
[AGENT][NEUTRAL] No, it's [PII], and your name is again? I'm sorry.
[CUSTOMER][NEUTRAL] Oh, [PII]
[AGENT][NEUTRAL] OK, and how may I assist you today, [PII]?
[CUSTOMER][NEUTRAL] I'm trying to verify that eligibility.
[CUSTOMER][POSITIVE] And benefits.
[AGENT][NEUTRAL] OK, I can verify benefits and eligibility for you. And what is that policy number, please?
[CUSTOMER][NEUTRAL] Sure, let me just grab it real quick.
[CUSTOMER][NEUTRAL] Policy number is
[CUSTOMER][NEUTRAL] See which 1, 02545379.
[AGENT][POSITIVE] OK, thank you so much and give me one moment.
[AGENT][NEUTRAL] And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, and verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] Or [PII]. Date of birth [PII].
[AGENT][NEUTRAL] OK, thank you. And will you say you're calling for eligibility and benefits, correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, I'm showing an effective date of [PII], policy is active, and what benefits are you needing for this patient?
[CUSTOMER][NEUTRAL] Specialist office visit.
[AGENT][NEUTRAL] OK, um, not a guarantee of payment, just a verification of coverage. The max payable for an office visit, whether specialist or general practitioner, is up to $25 per visit and they have a total or
[AGENT][NEUTRAL] Yeah, they have a total of 4 visits per year.
[CUSTOMER][NEUTRAL] 6
[CUSTOMER][NEUTRAL] Does that include all um any other services done in the office like ultrasound labs, is it the same?
[AGENT][NEUTRAL] Well, on the policy it just pays for the visit. It just pays up to $25. I guess if there's any other procedures and it goes towards that $25 benefit.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] I see. Anything beyond it will be there sir OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, I just want to confirm if this is the, like secondary or the primary insurance.
[AGENT][NEUTRAL] This is a secondary policy.
[CUSTOMER][NEUTRAL] On this
[CUSTOMER][NEUTRAL] Secondary, OK. Do you show which is the primary?
[AGENT][NEUTRAL] Uh, you have to contact the patient.
[CUSTOMER][NEUTRAL] Oh, OK, I see, but this is a secondary in your end, right?
[AGENT][NEUTRAL] Uh, correct, this is secondary online.
[CUSTOMER][NEUTRAL] Sector. OK, that is noted. All right, I think that's it. Um, you said it's [PII]. I'm sorry if I didn't catch it, right.
[AGENT][NEUTRAL] Uh, that is correct. [PII], last initial [PII]
[CUSTOMER][NEUTRAL] And then you have your own risk.
[AGENT][NEUTRAL] I'm sorry, say again.
[CUSTOMER][NEUTRAL] Reference number?
[AGENT][NEUTRAL] Uh, we don't give reference numbers, but if you like, you may use my name in today's date.
[CUSTOMER][NEUTRAL] OK, and as per the type of policy, is this like a PPO or like a self-funded?
[AGENT][NEUTRAL] No, this is a secondary supplemental policy.
[CUSTOMER][POSITIVE] OK, thank you, [PII]. That's all for today. Have a good one.
[AGENT][POSITIVE] Alright, you're welcome. You too, Will. Thank you for calling APL. Bye.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] Bye.