AccountId: 011433970860
ContactId: 7e65d8c5-785f-4993-b690-3b920fd56544
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 286209 ms
Total Talk Time (AGENT): 122781 ms
Total Talk Time (CUSTOMER): 71328 ms
Interruptions: 2
Overall Sentiment: AGENT=1.6, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/7e65d8c5-785f-4993-b690-3b920fd56544_20250304T14:48_UTC.wav
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[AGENT][NEUTRAL] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII]. I'm calling from Banner Health. I was trying to get eligibility and uh benefits on a patient.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, [PII], you're needing benefits and eligibility. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes ma'am, I can help you with those things and [PII], what is a good callback number for you please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And the member's policy number, please?
[CUSTOMER][NEUTRAL] Policy number is 02543575.
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] And [PII], any information that I do provide for you would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh [PII], date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] So I do show he is the subscriber on this limited benefit plan and it is active with an effective date of [PII] and what type of benefit information do you need for him inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Uh, office. A patient is coming in to see a cardiologist as a new patient.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Just one moment while my information is still loading.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome, thank you.
[AGENT][NEUTRAL] OK, so on this limited benefit plan that he has for outpatient accident and sickness treatment for a physician's office visit, the benefit is $50 per day and a maximum of 4 days per calendar year.
[CUSTOMER][NEUTRAL] And 4
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] And then, um, is that, does the 4 visits count for primary care and specialist combined or is it 4 for? OK.
[AGENT][POSITIVE] Yes, ma'am. Correct. Yeah, no, it's combined. It's just one benefit.
[CUSTOMER][NEUTRAL] OK. And then are you able to see um if the patient has used any of those four visits?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I can check that for you. One moment.
[AGENT][NEUTRAL] And as of now, no, ma'am, for this calendar year, he has not.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] And then once the claim has been processed, we do have a portal in which you should be able to check claim status and the portal website Nicole is secured. [PII].
[CUSTOMER][NEUTRAL] Um, OK, that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You said [PII], was it?
[AGENT][NEUTRAL] No, [PII]. [PII].
[CUSTOMER][NEUTRAL] [PII], OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK. Thank you. Uh, that is everything I needed. Can I just have a reference number for the call and that's everything?
[AGENT][POSITIVE] OK. Well, you're welcome.
[AGENT][NEUTRAL] Sure, yes, ma'am, if that's all I can help you with today, you would use my name along with today's date as your call reference number.
[CUSTOMER][POSITIVE] OK, thank you very much.
[AGENT][POSITIVE] OK. Well, you're welcome, [PII], and again, if that's all I can help with, thank you for calling APL and I hope you have a great day.
[CUSTOMER][POSITIVE] You as well thank you bye.
[AGENT][POSITIVE] Yes, ma'am. Thank you too. Bye-bye.