AccountId: 011433970860
ContactId: 92a4ff00-0149-4592-8353-554a2e06a4da
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 170509 ms
Total Talk Time (AGENT): 70366 ms
Total Talk Time (CUSTOMER): 34151 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/19/92a4ff00-0149-4592-8353-554a2e06a4da_20250519T12:32_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Thank you. My name is [PII]. I'm calling from the doctor's office. I need to check benefit and eligibility for specialist office visit, please.
[AGENT][POSITIVE] OK. Happy to check on benefits today, [PII]. What's the patient policy number?
[CUSTOMER][NEUTRAL] 22
[CUSTOMER][NEUTRAL] 40489.
[AGENT][NEUTRAL] And may I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you. So, patient is active. Effective date is [PII]. We are the members secondary insurance, so this covers deductible, co-pay, co-insurance. The primary does not.
[AGENT][NEUTRAL] This member's plan has an outpatient benefit max for the calendar year of 7900.
[CUSTOMER][NEUTRAL] So office visit is not covered.
[AGENT][NEUTRAL] Let me double check and see if their office visit is covered under this. Let me see.
[AGENT][NEUTRAL] OK, so patient plan is not gonna cover the physician office visit fee. It would just cover.
[AGENT][NEUTRAL] The actual, yeah, procedure and treatment in office, correct.
[CUSTOMER][NEUTRAL] Procedures.
[CUSTOMER][NEUTRAL] Up to 7000.
[AGENT][NEUTRAL] It's 7900, uh huh.
[CUSTOMER][NEUTRAL] And the accumulation?
[AGENT][NEUTRAL] Uh, let me see what they've used here, one moment.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Uh, looks like they've only used $4 for the year, so they pretty much have the full amount remaining.
[CUSTOMER][POSITIVE] Thank you sir I appreciate it.
[AGENT][NEUTRAL] You're welcome, [PII].
[CUSTOMER][POSITIVE] Have a nice day. Can I.
[AGENT][NEUTRAL] You too.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye-bye.