AccountId: 011433970860
ContactId: 8a3237b8-ee3f-4e73-a4b2-32c1efd50de2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 314350 ms
Total Talk Time (AGENT): 140721 ms
Total Talk Time (CUSTOMER): 83008 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/8a3237b8-ee3f-4e73-a4b2-32c1efd50de2_20250103T17:12_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi Miss [PII], good morning. I was calling to get some help with verifying eligibility for a few patients.
[AGENT][POSITIVE] Um, yes, ma'am. I can assist you with benefits. Um, first, I'll need your name and a good callback number.
[CUSTOMER][NEUTRAL] Yes, ma'am. My name is [PII], last initial [PII] Call back is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] I have 01841968.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Thank you and please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] We have [PII] 22064.
[AGENT][NEUTRAL] And just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII] and the policy is still active.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Um, is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Outpatient.
[AGENT][NEUTRAL] OK. OK, for outpatient, we cover up to 500 per day and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim.
[CUSTOMER][NEUTRAL] OK, and, uh, is there, um, the reference number is your first name, right?
[AGENT][NEUTRAL] Yes, ma'am. And today's date.
[CUSTOMER][NEUTRAL] Oh, OK. And then I have a second, uh, patient.
[AGENT][NEUTRAL] OK, one moment, please.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][POSITIVE] OK, thanks for your patience. I'm ready for the next policy number.
[CUSTOMER][NEUTRAL] I have 1548459.
[AGENT][NEUTRAL] Thank you and please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I found her in our system and just let me advise you that verification of coverage does not guarantee payment of claims, and she does have a new policy number.
[CUSTOMER][POSITIVE] OK, I am ready for it.
[AGENT][NEUTRAL] OK. The new number is 02458541.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Mhm. No problem. And the effective date on this policy was [PII].
[AGENT][NEUTRAL] The policy is still active.
[AGENT][NEUTRAL] And is this also for outpatient benefits?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, under this policy, we cover up to 5000 per calendar year for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim.
[CUSTOMER][NEUTRAL] Alrighty and then I have one last patient.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, I'm ready for the policy number.
[CUSTOMER][NEUTRAL] I have 02516888.
[AGENT][NEUTRAL] Thank you and please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] I have [PII] [PII].
[AGENT][NEUTRAL] OK, and again, just let me advise you that verification of coverage does not guarantee payment of claims. The effective date on this policy was [PII].
[AGENT][NEUTRAL] And the policy is still active.
[AGENT][NEUTRAL] Let's see, for outpatient benefits, we cover up to 1500 per calendar year for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim.
[CUSTOMER][POSITIVE] Alrighty and so that will be all.
[CUSTOMER][NEUTRAL] For today and the correct spelling for your last name, I'm sorry?
[AGENT][NEUTRAL] Um, it's [PII]
[CUSTOMER][POSITIVE] I'm sorry for your first name, my apologies for your first name.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] No problem. It's um [PII] and last initial is [PII].
[CUSTOMER][POSITIVE] Alrighty Ms. [PII], thanks so much for your help today. You have a great day and [PII].
[AGENT][NEUTRAL] Same to you, [PII]. Thank you for calling APL. Mm bye.
[CUSTOMER][POSITIVE] Thank you bye bye.