AccountId: 011433970860
ContactId: 94a4e568-2221-4210-bfad-49381136520b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 136699 ms
Total Talk Time (AGENT): 74578 ms
Total Talk Time (CUSTOMER): 47813 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/94a4e568-2221-4210-bfad-49381136520b_20250218T13:08_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII]. I'm trying to check um eligibility and benefits of a patient, please.
[AGENT][NEUTRAL] I'm sure, [PII], I can assist you with benefits. Um, first, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure. It's [PII].
[AGENT][NEUTRAL] Thank you. Now I need your policy number, please.
[CUSTOMER][NEUTRAL] Policy number is 02270600.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Her name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you and just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII]. The policy is still active. And is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Um, outpatient office visit, specialist office visit.
[AGENT][NEUTRAL] OK. Actually, services provided in the doctor's office is not covered under this policy.
[AGENT][NEUTRAL] Yeah, I'm only sure.
[CUSTOMER][NEUTRAL] If it's in a doctor's office, it's not covered?
[AGENT][NEUTRAL] That's correct. This is for secondary gap insurance. What we do is cover the copay, the co-insurance, and deductible after the primary insurance processes the claim. But for this policy, I'm only showing coverage for inpatient and outpatient hospital services and urgent care facilities.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] Oh, OK, inpatient or outpatient but for hospital. OK, perfect.
[AGENT][POSITIVE] That's correct, yes, ma'am.
[CUSTOMER][NEUTRAL] I got you. OK, my dear, do you have a call reference for me, please?
[AGENT][NEUTRAL] Um, yes, for the reference number, you can use my name and today's date. My name is [PII]. Um, 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 will be all for today. Thank you. I appreciate your help and have a good day.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL. Bye.
[CUSTOMER][NEUTRAL] Bye.