AccountId: 011433970860
ContactId: 88f8394b-439f-412e-a7b3-e9f8f0420188
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 259928 ms
Total Talk Time (AGENT): 95249 ms
Total Talk Time (CUSTOMER): 53366 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/88f8394b-439f-412e-a7b3-e9f8f0420188_20250403T20:15_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yes, I'm calling for benefits and eligibility please for one of our patients.
[AGENT][NEUTRAL] Hi.
[AGENT][POSITIVE] OK, I can help you with benefits and eligibility. Could I get your name and a good callback number?
[CUSTOMER][NEUTRAL] Yes, um it's gonna be [PII].
[CUSTOMER][NEUTRAL] The callback number is gonna be [PII].
[AGENT][NEUTRAL] OK, thank you. And do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Yes, 02419336.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] Of course, the patient's name is gonna be for [PII] and it's gonna be [PII] of [PII].
[AGENT][NEUTRAL] OK, it looks like this policy is termed, but let me see if he's got an active one.
[AGENT][NEUTRAL] Um.
[AGENT][NEUTRAL] OK, looks like I do have an active policy. Um, can I give you that number?
[CUSTOMER][NEUTRAL] Yes, of course, give me one moment please and.
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, so that policy number is 2,556,440.
[CUSTOMER][NEUTRAL] OK, so it's 2,556,440.
[AGENT][POSITIVE] Yes, that's correct. And you need the benefits, was that right?
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Yes, an eligibility please.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Of course.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] OK, it's not a guarantee of payment. It's a basic outline of the policy. I show the policy is active 101-2024. Policy is current and active.
[AGENT][NEUTRAL] And let's see, is this for outpatient benefits?
[CUSTOMER][NEUTRAL] For an office. Yeah, it's gonna be for a specialist office visit and outpatient surgery.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me get that pulled up, just one moment.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] [PII], because I have an outpatient benefit maximum it'll pay out 8700 per calendar year.
[AGENT][NEUTRAL] Um, this is a secondary policy, so we'll need the primary explanation of benefits and when you file the claim.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, I do not show there's no benefit for the office visit itself, but any services like procedures or services performed in the office would be covered under that benefit.
[CUSTOMER][NEUTRAL] OK, so the office visit is not covered, no problem.
[CUSTOMER][NEUTRAL] And then how much has been accumulated, please?
[AGENT][NEUTRAL] Um, let's see.
[AGENT][NEUTRAL] Um, so far this year.
[AGENT][NEUTRAL] Yeah, these are
[AGENT][NEUTRAL] He has used a total of 59 26 87.
[AGENT][NEUTRAL] 5,95921
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] And a reference number please?
[AGENT][NEUTRAL] Reference number will be my first name, [PII], first initial last name, [PII], and today's date.
[CUSTOMER][POSITIVE] OK, thank you so much [PII] you have a great rest of your day.
[AGENT][POSITIVE] OK, thank you for calling APL. You too. Bye.
[CUSTOMER][NEUTRAL] Mm bye.