AccountId: 011433970860
ContactId: 9028fd13-4896-4c8e-ae62-755a6e737a5e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 215229 ms
Total Talk Time (AGENT): 91796 ms
Total Talk Time (CUSTOMER): 72216 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/9028fd13-4896-4c8e-ae62-755a6e737a5e_20250130T15:40_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APR. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. Uh, my name is [PII]. I'm calling to verify the eligibility and benefits of a patient.
[AGENT][NEUTRAL] I'm sure [PII], I can assist you with benefits. Um, first, I'll need a good callback number just in case we're disconnected.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK. Thank you. Um, now I need the policy number, please.
[CUSTOMER][NEUTRAL] 020375 M. 3 M as in Mike, L as in Larry, and the number 8.
[AGENT][NEUTRAL] OK. And you said that number was 020375?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, no one's coming up under that policy number. Um, do you have the member's social or I can look them up by name and date of birth?
[CUSTOMER][NEUTRAL] Um, I can give you the name and date of birth. I don't have his social. It's, uh, the last name is [PII]
[CUSTOMER][NEUTRAL] First name is [PII], and uh his date of birth is [PII].
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, I found him in our system. Um, would you like his policy number?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] His policy number is 024.
[AGENT][NEUTRAL] 93487.
[CUSTOMER][NEUTRAL] 024934887
[AGENT][POSITIVE] Yes, ma'am. That's correct.
[CUSTOMER][NEUTRAL] OK. Uh, the claims address and everything else stays the same, right?
[AGENT][NEUTRAL] Um, what address are you showing?
[CUSTOMER][NEUTRAL] I'm showing uh [PII].
[AGENT][POSITIVE] Yes, that's correct. It stays the same.
[CUSTOMER][POSITIVE] OK, perfect. Thank you so much.
[AGENT][NEUTRAL] Mm, no problem. And just let me advise you that verification of coverage does not guarantee payment of claims. The effective date on this policy was [PII] and the policy is still active. Um, is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Outpatient benefits.
[AGENT][NEUTRAL] OK, for outpatient, we cover up to 5300 per calendar year and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim.
[CUSTOMER][NEUTRAL] OK. Um, perfect. Is there a reference number for the call?
[AGENT][NEUTRAL] For the reference number, you can use my name and today's date. My name is [PII]. It's spelled [PII] and my last initial is [PII] and today's date. Is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] No, that was all. Thank you so much.
[AGENT][POSITIVE] OK. Thank you, [PII], for calling APL. You have a great rest of your day. Mm bye.
[CUSTOMER][POSITIVE] You too. Thank you. Bye-bye.
[AGENT][NEUTRAL] Mhm. OK.