AccountId: 011433970860
ContactId: 9592d4c9-7328-4747-94b6-cf71704e8aa5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 159190 ms
Total Talk Time (AGENT): 82843 ms
Total Talk Time (CUSTOMER): 61331 ms
Interruptions: 0
Overall Sentiment: AGENT=2, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/29/9592d4c9-7328-4747-94b6-cf71704e8aa5_20250129T13:35_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I am calling to get benefits and eligibility for a patient for an office visit specialist visit, please.
[AGENT][POSITIVE] It would be my pleasure to assist you this morning. Excuse me with those benefits. What is your name, please?
[CUSTOMER][NEUTRAL] [PII], that's [PII]
[AGENT][POSITIVE] Thank you, [PII] a good callback number, please.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And [PII], what is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] Um, it is.
[CUSTOMER][NEUTRAL] Let's see what she has on here.
[CUSTOMER][NEUTRAL] It has a coverage and a group number.
[AGENT][NEUTRAL] At the bottom.
[CUSTOMER][NEUTRAL] An effective date on this card?
[AGENT][NEUTRAL] Is there an inpatient or outpatient benefit cert number at the bottom?
[CUSTOMER][NEUTRAL] Yes, 01813090 ML 8.
[AGENT][NEGATIVE] And my hats off to y'all. I don't know how y'all read all the different insurance cards and know where to find everything.
[CUSTOMER][NEUTRAL] Oh
[AGENT][POSITIVE] Much respect.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, [PII] [PII].
[AGENT][NEUTRAL] All right, thank you, and I can help you with that eligibility and office visit benefit. Now, for [PII], the policy is active. Effective date is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] This is a secondary policy to her major medical insurance.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now for the
[AGENT][NEUTRAL] Um, office visit, the visit is not covered.
[CUSTOMER][NEUTRAL] OK, it's not covered. OK, OK, so what, what does this cover because she just gave us this, so what does this cover?
[AGENT][NEUTRAL] And now if you perform.
[AGENT][NEUTRAL] Mhm. So if there are any procedures or treatments performed during the office visit or in a doctor's office, that is covered, but the office visit is not.
[CUSTOMER][NEUTRAL] OK, got it. So if, if she were to have like um like let's just say she's if she had like an outpatient infusion therapy, would that be covered?
[AGENT][NEUTRAL] That would be a treatment and could be considered for payment under her policy under the outpatient benefit.
[CUSTOMER][POSITIVE] OK, OK, I will let her know thank you so much.
[AGENT][POSITIVE] It's been such a pleasure to assist you, [PII]. Anything else I can help you with today?
[CUSTOMER][POSITIVE] No, you've been more than helpful thank you.
[AGENT][POSITIVE] And thank you for calling APL. I hope you have a wonderful day.
[CUSTOMER][NEUTRAL] Uh huh bye bye.
[AGENT][NEUTRAL] Bye bye.