AccountId: 011433970860
ContactId: 8543d56b-f643-441c-83ad-cb12e1cca7e0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 250460 ms
Total Talk Time (AGENT): 98329 ms
Total Talk Time (CUSTOMER): 72468 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/8543d56b-f643-441c-83ad-cb12e1cca7e0_20250402T18:31_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello [PII]. I'm checking eligibility and benefits, please.
[AGENT][POSITIVE] OK, I can definitely help you with both the eligibility and benefits. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, absolutely. Uh, my name is [PII], it's [PII], phone number [PII], no extension.
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] And it is 1 I'm sorry 01369753.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][POSITIVE] All right, thanks.
[AGENT][NEUTRAL] You're welcome. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] This was from [PII], um, [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment, and I am showing the policy is active, it's been effective since [PII].
[CUSTOMER][NEUTRAL] No, and they, right?
[AGENT][NEUTRAL] Uh, yes, no, um, future term date.
[CUSTOMER][NEUTRAL] I see.
[AGENT][NEUTRAL] And what type of um benefits did you want to go over? Would it be outpatient? Oh, I'm sorry.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][POSITIVE] Oh yeah, I'm so sorry to interrupt go ahead.
[AGENT][NEUTRAL] It would, no, I was just asking with the, are you looking for outpatient benefits or inpatient?
[CUSTOMER][NEUTRAL] Those are outpatient specialists. I, I'd like to verify first if this is um if you're showing a secondary.
[AGENT][NEUTRAL] Yes, we're secondary.
[CUSTOMER][NEUTRAL] Is that, is it a supplement plan or no?
[AGENT][NEUTRAL] Um, it's a supplemental gap insurance policy. So we pay towards the copay, deductible and co-insurance.
[CUSTOMER][NEUTRAL] How it is.
[AGENT][NEUTRAL] Of covered charges after primary.
[CUSTOMER][NEUTRAL] Oh, you did. OK.
[CUSTOMER][NEUTRAL] And does that include um specialist offices and minor diagnostic tests in the specialist office?
[AGENT][NEUTRAL] So the policy, let me see if I see, hold on one moment.
[CUSTOMER][POSITIVE] Sure, yeah, no problem.
[AGENT][NEUTRAL] Let me pull up the big one. Do you mind if I place you on just a brief hold?
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] All right, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm. You are on hold.
[AGENT][NEUTRAL] OK, this the old benefits, so it's just 1000 per calendar day, OK.
[AGENT][NEUTRAL] But hold on.
[AGENT][NEGATIVE] They don't have any off OK.
[AGENT][NEUTRAL] Hello [PII].
[CUSTOMER][NEUTRAL] Yep, I'm here.
[AGENT][NEUTRAL] Alright, thank you so much for holding. I apologize for that wait. So this policy doesn't have any coverage for the um in-office setting. It's only outpatient facilities in which we would pay up to $1000 per calendar day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, so no office coverage. Anything done in the office might may it be PCP or um sorry, specialist, right?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Right, anything in the office setting, yes, ma'am.
[CUSTOMER][NEUTRAL] I see. All right. Can I get a reference number?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name and today's date. The first initial to my last name is [PII] like [PII] and my name is [PII]
[CUSTOMER][POSITIVE] Thanks, [PII]. Have a good one.
[AGENT][POSITIVE] You're welcome. Was there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, that's it. Thanks. Have a good day. Bye bye.
[AGENT][POSITIVE] Alright, thanks for calling APL bye bye.