AccountId: 011433970860
ContactId: 7dcd0c49-2653-438f-baaa-75f74803319b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 258440 ms
Total Talk Time (AGENT): 96173 ms
Total Talk Time (CUSTOMER): 75211 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/7dcd0c49-2653-438f-baaa-75f74803319b_20250124T13:45_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, good morning. This is [PII] last [PII], and I would like to check benefits information, please.
[AGENT][NEUTRAL] I can help you, [PII], and what type of benefit?
[CUSTOMER][NEUTRAL] Um, I'm looking for a PCP office visit, well visit and outpatient benefits.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. And what's the policy number?
[CUSTOMER][NEUTRAL] Member ID number it's 235.
[CUSTOMER][NEUTRAL] 3168.
[AGENT][NEUTRAL] And what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. Can you repeat the last four digits?
[CUSTOMER][NEUTRAL] Um, sure. It's [PII].
[AGENT][POSITIVE] [PII]. Thank you.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] The patient's name and date of birth?
[CUSTOMER][NEUTRAL] First name is [PII]. Last name is
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for that information, [PII]. And so we're checking eligibility, office visit, well visit and outpatient uh facility benefits.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so the policy effective date is [PII].
[AGENT][NEUTRAL] So wellness visits are not covered under this policy?
[AGENT][NEUTRAL] The office visit co-pay or the physician visit fee is not covered under the policy. Um, however, there is a treatment writer. So if there's covered treatment during the course of the
[AGENT][NEUTRAL] Um, visit those items can be considered under the outpatient benefit and that benefit is up to $2000 per calendar year.
[AGENT][NEUTRAL] And of course the information provided is verification, not a guarantee of payment.
[AGENT][NEUTRAL] I don't show any claims on file.
[AGENT][NEUTRAL] Uh, for this year at this time.
[AGENT][NEUTRAL] Any other questions?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, no. So for PTP, well, visits are not covered and outpatient benefits, it's up to $2000 right?
[AGENT][NEUTRAL] Per calendar year.
[CUSTOMER][NEUTRAL] For calendar year, OK, and could you provide me what is the claims address?
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, thank you. Um, could you please provide me what is the car reference number and may I have your name as well?
[AGENT][NEUTRAL] My
[AGENT][NEUTRAL] You'll use my name in today's date as your reference, [PII]
[AGENT][NEUTRAL] First initial last name is [PII], and any other questions I can help out with today?
[CUSTOMER][POSITIVE] Um, no, thank you. So, all right, thank you and have a great day.
[AGENT][POSITIVE] You're welcome. Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] OK, you too.
[CUSTOMER][NEUTRAL] Uh