AccountId: 011433970860
ContactId: 934a57d8-16d8-4d8c-a90e-b865ed4953e1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 354700 ms
Total Talk Time (AGENT): 119644 ms
Total Talk Time (CUSTOMER): 95654 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/934a57d8-16d8-4d8c-a90e-b865ed4953e1_20250610T22:06_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. How are you? My name is [PII] and I'm calling to verify members eligibility requirements and benefits.
[AGENT][POSITIVE] Sure I can help you with eligibility and benefits. [PII], can I get a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] That is 663-801.
[AGENT][NEUTRAL] 663-3801
[CUSTOMER][NEUTRAL] Uh, no, 663-801.
[AGENT][POSITIVE] Oh OK, I'm so sorry, give me just one moment.
[CUSTOMER][POSITIVE] No worries. Mhm.
[AGENT][NEUTRAL] Can I get you to verify the patient's name and date of birth for me, please?
[CUSTOMER][NEUTRAL] Yes, [PII], [PII].
[AGENT][NEUTRAL] OK, one second. 663-801, correct?
[CUSTOMER][POSITIVE] No problem
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, that is not the policy number for that patient.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, let me double check here.
[CUSTOMER][NEUTRAL] Would you like the group number or the date of birth?
[AGENT][NEUTRAL] Um, do you have their last name or social?
[CUSTOMER][NEUTRAL] And first and last name.
[CUSTOMER][NEUTRAL] I have the last name [PII]. It's [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, let me look at it that way. Just give me one moment and you said the first name was [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. Give me one moment.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] All right, let me look here.
[AGENT][NEUTRAL] And what did you say the date of birth was?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you so much.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] Alright, and would you like the uh policy number?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, it's 0247.
[AGENT][NEUTRAL] 0163.
[CUSTOMER][NEUTRAL] OK, I have 02470163.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] Perfect thank you so much appreciate that.
[AGENT][NEUTRAL] And that policy, you're welcome. That policy has an effective date of [PII], and it is active.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It is a Medlink policy, so it's secondary gap insurance.
[AGENT][NEUTRAL] And let me see here.
[AGENT][NEUTRAL] Anyone with benefits, correct?
[CUSTOMER][NEUTRAL] Yes, and just to confirm, since it's a gap policy, no office is required, correct?
[AGENT][NEUTRAL] Uh, correct me.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Did you need inpatient or outpatient?
[CUSTOMER][NEUTRAL] Outpatient.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] This is a verification of benefits, not a guarantee of payment. It looks like she has an outpatient benefit maximum of up to $2000 per calendar year.
[AGENT][NEUTRAL] With a maximum of $6000 per calendar year for all covered persons combined.
[AGENT][NEUTRAL] With a $0 deductible for outpatient services.
[CUSTOMER][NEUTRAL] OK, and has any of that been met?
[AGENT][NEUTRAL] Let me look.
[AGENT][NEUTRAL] It looks like she has used $243 of that so far.
[CUSTOMER][NEUTRAL] OK, perfect. And just to confirm, what is the group number I have here 259-62 is that still correct?
[AGENT][NEUTRAL] You what?
[AGENT][NEUTRAL] 25962, yes.
[CUSTOMER][NEUTRAL] Perfect. OK. And I also have a claim address as [PII] [PII].
[AGENT][NEUTRAL] Yes, ma'am, that is our claims.
[CUSTOMER][POSITIVE] Perfect, thank you so very much, [PII]. Is there a call reference number?
[AGENT][NEUTRAL] Uh, we don't have call reference numbers, but you can use my name and last initial in today's date. So [PII] and today's date.
[CUSTOMER][POSITIVE] Perfect. Thank you so much. You have a great day.
[AGENT][POSITIVE] OK, thank you for calling APL. You have a great day too.
[CUSTOMER][POSITIVE] Thanks bye bye.
[AGENT][NEUTRAL] Bye.