AccountId: 011433970860
ContactId: 93e859f9-f320-4fab-95f9-5021bea9797c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 209339 ms
Total Talk Time (AGENT): 91583 ms
Total Talk Time (CUSTOMER): 64326 ms
Interruptions: 1
Overall Sentiment: AGENT=2.1, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/93e859f9-f320-4fab-95f9-5021bea9797c_20250121T13:37_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning [PII]. My name is [PII]. Can I have your last name initial?
[AGENT][NEUTRAL] [PII] yours?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you. And how can I help you today, [PII]?
[CUSTOMER][NEUTRAL] Um, I, we have a patient who has, um, this gap insurance, and we just want to know exactly what it covers.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so you, do you need eligibility and some benefit information, is that correct? Or just benefits?
[CUSTOMER][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Both.
[AGENT][NEUTRAL] OK. Yes, ma'am. I can help you with that. And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] My callback number is [PII].
[AGENT][POSITIVE] Thank you. And the member's policy number, please.
[CUSTOMER][NEUTRAL] That would be 02441468 M as in Mike L as in Lima 8.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] One moment, please.
[AGENT][NEUTRAL] And any information [PII] that I do provide for you will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Um, patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, so I do show that he is the subscriber on the supplemental policy and it is active with an effective date of [PII].
[AGENT][NEUTRAL] And what type of benefit information are you needing for him inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, office
[AGENT][NEUTRAL] OK. So, on this policy, office visits are not covered.
[CUSTOMER][NEUTRAL] OK, so co-pays are not covered.
[AGENT][MIXED] That is correct, not for office visits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so it, it only covers basically like coinsurance for like an outpatient visit, right?
[AGENT][NEUTRAL] Yes, things, yes, done outpatient diagnostic uh a freestanding facility or you know, hospital, um, but things
[AGENT][NEUTRAL] Visits and treatment in the office is not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright, perfect. Can I get a call reference number please?
[AGENT][NEUTRAL] Sure, yes, ma'am. You would use my name along with today's date.
[CUSTOMER][NEUTRAL] OK, and your name is [PII]?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Oh, [PII] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Perfect, thank you very much, [PII]. I appreciate your help and you have a wonderful rest of your day.
[AGENT][POSITIVE] Yes, ma'am, with you.
[AGENT][POSITIVE] Well, I hope you have a wonderful day too, and thank you again for calling APL.
[CUSTOMER][POSITIVE] Thank you have a great day bye.
[AGENT][POSITIVE] Mhm. You're welcome. You too. Bye-bye.