AccountId: 011433970860
ContactId: 9017484e-278d-4ffa-b008-5af0424e4dc5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 160820 ms
Total Talk Time (AGENT): 51469 ms
Total Talk Time (CUSTOMER): 66181 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/9017484e-278d-4ffa-b008-5af0424e4dc5_20250421T16:45_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] and I'm calling from Prisma Health trying to verify some benefits and eligibility on a patient.
[AGENT][NEUTRAL] Hey, [PII], I can help you with benefits and eligibility. Do you have a good callback number?
[CUSTOMER][NEUTRAL] I do. It's [PII], and that is a direct line.
[AGENT][NEUTRAL] OK, thank you. And the policy number of the patient?
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] The policy number is, let me get to that, 02516613.
[AGENT][NEUTRAL] And the patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK, and is this for outpatient services or what type of services?
[CUSTOMER][NEUTRAL] It is, um, it's for I'm specifically calling about like office um office services like for a specialist or primary care if this um plan pays on that.
[AGENT][NEUTRAL] OK, let me check that. Let me get it pulled up. I show the policy is effective [PII], policy is active.
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] And see what the benefits are.
[AGENT][NEUTRAL] This is not a guarantee of payment. It's a basic outline of the policy.
[AGENT][NEUTRAL] OK, let's see.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Um, so they have a $75 maximum benefit payable for um office visits.
[CUSTOMER][NEUTRAL] OK, and is there a limit on those office visits?
[AGENT][NEUTRAL] Um, it looks like it is 5.
[CUSTOMER][NEUTRAL] 5 office visits per calendar year.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, and do you know if he's used any of these yet or do y'all keep track of that?
[AGENT][NEUTRAL] Uh yes, let me double check.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, don't show anything used this year.
[CUSTOMER][NEUTRAL] OK, so he's got 5 remaining. OK, up to $75 per office visit and [PII], do you give um call reference numbers?
[AGENT][NEUTRAL] That's just my name, [PII], first initial to last name, [PII], and today's date.
[CUSTOMER][POSITIVE] OK, great. Thank you so much and I hope you have a wonderful week.
[AGENT][POSITIVE] OK, thank you for calling APL. You as well.
[CUSTOMER][POSITIVE] Thank you, bye bye.