AccountId: 011433970860
ContactId: 8a5f21e7-4ce5-4402-aebe-ced5cd54798b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 146100 ms
Total Talk Time (AGENT): 81215 ms
Total Talk Time (CUSTOMER): 38712 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/8a5f21e7-4ce5-4402-aebe-ced5cd54798b_20250414T16:02_UTC.wav
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[CUSTOMER][NEUTRAL] Anything works
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Can we
[CUSTOMER][NEUTRAL] Hi [PII], I was calling to see if I could get eligibility and benefits for a patient, please, ma'am.
[AGENT][POSITIVE] Yes, ma'am, I can assist you with benefits. Um, first, could I get your name and a good callback number?
[CUSTOMER][NEUTRAL] Sure, it's [PII] and the phone number is [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now, could I get the policy number, please?
[CUSTOMER][NEUTRAL] Yes ma'am, 02579124.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Mr. [PII], uh, well, last name is [PII]. His first name is [PII] and his birthday is uh [PII].
[AGENT][NEUTRAL] OK, just let me advise you the verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII]. The policy is still active. And is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] It's a PCP office visit.
[AGENT][NEUTRAL] OK. Actually, under this policy, office visits um is not covered unless he's going for cancer treatment.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, this is secondary gap insurance. Normally, we cover the copay, the co-insurance, or the deductible after the primary insurance company processes the claim. Um, but under this policy, I'm only showing coverage for inpatient and outpatient hospital services. And there is, like I said, office visit treatment, but it's only for um um cancer treatment.
[CUSTOMER][NEUTRAL] OK, can I have a reference number for this call, EB?
[AGENT][NEUTRAL] Um, yes, for the reference number, you can use my name and today's date. Um my name is spelled [PII] Last initial [PII], and today's date. Um, is there anything else I can assist you with?
[CUSTOMER][POSITIVE] No ma'am, that's it thank you.
[AGENT][POSITIVE] Mhm. I thank you again O for calling APL. You have a great rest of your day. Mm bye.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Mm thank you.