AccountId: 011433970860
ContactId: 8882a9d8-abbc-4962-8dc4-2ccd16206e8d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 174639 ms
Total Talk Time (AGENT): 73069 ms
Total Talk Time (CUSTOMER): 42592 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/8882a9d8-abbc-4962-8dc4-2ccd16206e8d_20250414T18:03_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, I'm just calling to check eligibility. I'm calling from Hillsborough Internal Medicine.
[AGENT][POSITIVE] Yes ma'am, I can assist you with benefits. Um, first, could I get your name and a good call back number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, my first name is [PII], that's [PII]
[CUSTOMER][NEUTRAL] And phone number is [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now, could I get the policy number, please?
[CUSTOMER][NEUTRAL] Yeah her policy number is D like Delta 468.
[CUSTOMER][NEUTRAL] 02301.
[AGENT][NEUTRAL] OK, that's not one of our policy numbers. Um, do you have the member's social or I can look them up by name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, her name, oh wait, I'm sorry, the policy number, let me get that to you again.
[CUSTOMER][NEUTRAL] Is 02595710.
[AGENT][NEUTRAL] OK, thank you. Now, please verify her name and date of birth.
[CUSTOMER][NEUTRAL] p.m.
[CUSTOMER][NEUTRAL] [PII] [PII].
[CUSTOMER][NEUTRAL] Here
[AGENT][NEUTRAL] OK. And 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 and is this for inpatient or outpatient benefits or for an office visit?
[CUSTOMER][NEUTRAL] Uh, for an office visit with her PCP.
[AGENT][NEUTRAL] OK, one moment. Her benefits are coming up.
[CUSTOMER][NEUTRAL] OK
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, thanks for your patience. I'm showing that this is a limited hospital indemnity plan, um, but we do cover some outpatient services and for office visits, we cover up to $50 per visit and she gets 4 visits per calendar year and that's include um the PCP. All of, all office visits are covered the same.
[CUSTOMER][NEUTRAL] OK, so $50 and then 4 visits a year.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Perfect. OK, that's what I needed thank you so much.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. Is there anything else I can assist you with?
[CUSTOMER][POSITIVE] No, I appreciate it thank you.
[AGENT][POSITIVE] OK, thank you again, [PII] for calling APL. Have a great rest of your day. Mm bye.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][POSITIVE] Thank you