AccountId: 011433970860
ContactId: 9646315d-30b4-44c2-9718-07bebead6108
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 222600 ms
Total Talk Time (AGENT): 105700 ms
Total Talk Time (CUSTOMER): 68178 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/9646315d-30b4-44c2-9718-07bebead6108_20250610T20:14_UTC.wav
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[AGENT][NEUTRAL] For calling. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh yes, I'm calling to verify uh benefits for a patient please.
[AGENT][POSITIVE] Yes, ma'am. I can assist you with benefits. Um, first, I'll need your name and a good callback number.
[CUSTOMER][NEUTRAL] It's [PII] and the number is [PII].
[CUSTOMER][NEUTRAL] 0455.
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] That would be 0165987.
[CUSTOMER][NEUTRAL] M as in Mary, L as in Larry, 8.
[AGENT][NEUTRAL] OK. Please repeat the policy number.
[CUSTOMER][NEUTRAL] 016598887.
[CUSTOMER][NEUTRAL] M as in Mary, L as in Larry, and the number 8.
[AGENT][NEUTRAL] Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Last name [PII]. Date of birth [PII].
[AGENT][NEUTRAL] OK, thank you and just let me advise you that verification of coverage does not guarantee payment of claims. Um, he does have a new policy number.
[CUSTOMER][NEUTRAL] OK, let me update that OK.
[CUSTOMER][NEUTRAL] OK, go ahead.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, the new policy number is 024.
[AGENT][NEUTRAL] 97472.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, 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] Uh, specialist office is it.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] OK, for office visits, we cover up to $2500 per calendar year and that's for the um co-insurance and the deductible, and then the copay for office visits, we cover up to $60 per visit and he gets 4 visits per calendar year. I'm sorry, we cover up to 50 $50.
[AGENT][NEUTRAL] Provision for specialist.
[CUSTOMER][NEUTRAL] $50.
[AGENT][NEUTRAL] Yes, ma'am, for the co-pay.
[AGENT][NEUTRAL] And he gets 4 visits per calendar year and so far he's used 1, so he has 3 remaining.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And you said how much for the um deductible and co-insurance?
[AGENT][NEUTRAL] Um, 2500 per calendar year.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh right.
[CUSTOMER][NEUTRAL] All right, perfect. All right, that's what I wanted to verify. Could I just get a reference number for the call please?
[AGENT][NEUTRAL] Um, yes, ma'am. So the reference number, you can use my name and today's date. My name is Evie, um it's spelled [PII] and the last initial is M like [PII], and today's date. Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][POSITIVE] No, that's all thank you so much for your help.
[AGENT][POSITIVE] OK, thank you, [PII], for calling APL. You have a great rest of your day. Mm bye.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][POSITIVE] Mm thanks.