AccountId: 011433970860
ContactId: 7e539fde-c5ee-446a-ad4d-d4052011f82d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 221619 ms
Total Talk Time (AGENT): 115049 ms
Total Talk Time (CUSTOMER): 84744 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/7e539fde-c5ee-446a-ad4d-d4052011f82d_20250514T13:20_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, I'm looking for benefits for this patient.
[AGENT][POSITIVE] Um, yes, sir. I can assist you with benefits. Um, first, I'll need your name and a good callback number.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] My name is [PII] last name initial [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] 01978211 M as in mascot, L as in Lima, and 8.
[AGENT][NEUTRAL] I'm sorry. Could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] And date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And let me get the policy number one more time, please.
[CUSTOMER][NEUTRAL] 01978211 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] and her date of birth is [PII].
[AGENT][NEUTRAL] You can just let me advise you that verification of coverage does not guarantee payment of claims. Um, I'm showing the effective date on this policy was [PII]. The policy is still active, um, but she does have a new policy number.
[CUSTOMER][NEUTRAL] What's your new policy number?
[AGENT][NEUTRAL] Her new policy number is 025.
[AGENT][NEUTRAL] 894 56.
[CUSTOMER][NEUTRAL] 0258489456
[AGENT][NEUTRAL] Um, it's 025.
[AGENT][NEUTRAL] 89456.
[CUSTOMER][POSITIVE] Yeah, I got it thank you.
[AGENT][POSITIVE] No problem.
[AGENT][NEUTRAL] And is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Office, um, she had, she had an office um surgery.
[AGENT][NEUTRAL] OK, let's see. Are you checking on the status of that claim or just um verifying the benefits?
[CUSTOMER][POSITIVE] The benefits.
[AGENT][NEUTRAL] OK. Yes, I'm showing that for services provided in office.
[CUSTOMER][NEUTRAL] What is the number for when I'm
[CUSTOMER][NEUTRAL] Uh, give me the number.
[AGENT][NEUTRAL] We cover up to 4700 per calendar year and that's for the co-insurance and the deductible after the primary insurance processes the claim.
[CUSTOMER][NEUTRAL] How about for copays? Um, can you.
[AGENT][NEUTRAL] Um, co-pays for office visits is not covered.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh, OK, because she she has a copay for her office surgery.
[AGENT][NEUTRAL] OK. Yeah, um, for that, for the surgery, again, the co-insurance and deductible, that's covered, but if there's a co-pay, yeah, there it's not covered.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] Thank you for calling it has she met any of her?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Benefit
[AGENT][NEUTRAL] Um, no, not for this year. The full 4700 is available.
[CUSTOMER][NEUTRAL] Got it. May I have a reference number please?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. My name is [PII]. Um it's spelled [PII] My last initial is [PII], and today's date. Um, is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] N
[CUSTOMER][POSITIVE] No, that'll be all thank you very much, [PII].
[AGENT][POSITIVE] Yeah, thank you, [PII], for calling APL. You have a great day. Mm bye.
[CUSTOMER][NEUTRAL] You as well bye bye.
[AGENT][POSITIVE] Thank you