AccountId: 011433970860
ContactId: 982dc251-2352-4183-9354-10b7bdd5daf1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 196679 ms
Total Talk Time (AGENT): 96258 ms
Total Talk Time (CUSTOMER): 69125 ms
Interruptions: 2
Overall Sentiment: AGENT=1.1, CUSTOMER=2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/06/982dc251-2352-4183-9354-10b7bdd5daf1_20250506T13:29_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I assist you?
[CUSTOMER][POSITIVE] Hi, good morning. I'm calling to get a patient's eligibility and benefits.
[AGENT][POSITIVE] Sure, I can assist you with that. Can I have your name and a callback number?
[CUSTOMER][NEUTRAL] Yes, it's [PII] and then phone number is [PII].
[AGENT][NEUTRAL] [PII], can you provide me with the spelling of your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what is the policy number of the member that you're calling to verify benefits eligibility for today?
[CUSTOMER][NEUTRAL] Would it be the outpatient benefit cert number?
[AGENT][NEUTRAL] Either number inpatient or outpatient is gonna pull up the policy.
[CUSTOMER][NEUTRAL] 02220000 ML 8.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Give me that number again.
[CUSTOMER][NEUTRAL] 0222.
[CUSTOMER][NEUTRAL] 0000.
[CUSTOMER][NEUTRAL] ML 8.
[AGENT][NEUTRAL] It's 40s after the 32s.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Could you verify the patient's name and date of birth, and I'll be able to assist you.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] So let me give you the correct policy number. Let me know when you're ready for it.
[CUSTOMER][NEUTRAL] OK, go ahead.
[AGENT][NEUTRAL] It is 2581436.
[CUSTOMER][NEUTRAL] Yes, go ahead.
[CUSTOMER][POSITIVE] Oh OK perfect thank you so much.
[AGENT][NEUTRAL] This policy has been active since [PII] and it's currently active. You're calling to verify outpatient benefits?
[CUSTOMER][NEUTRAL] Yes, for a dermatology office.
[AGENT][NEUTRAL] So the member's policy does not cover the office visit itself, however, procedures done in the office falls under his outpatient benefits of $250 per calendar day, and this is not a guarantee of benefits, just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] OK, so you said it does not cover office visit but it covers procedures up to.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] $250 per calendar day.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, is that it?
[AGENT][NEUTRAL] Yes ma'am, that is, that is it. That is all of its benefits, and this is not a guarantee of benefits, that's a disclaimer of the policy's coverage. No, this is a gap insurance.
[CUSTOMER][POSITIVE] Perfect. It doesn't have a deductible, no coinsurance.
[AGENT][NEUTRAL] It assists with the deductible copay and co-insurance to the primary.
[CUSTOMER][POSITIVE] Perfect. OK.
[CUSTOMER][POSITIVE] Perfect. Can I just get a reference number, please?
[AGENT][NEUTRAL] Is there anything else that I can assist you with today? We don't provide those, [PII], however, you can use my name and today's date as a reference is [PII] and today's date as a reference.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] What was the name? [PII]?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh [PII] and then today's date.
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][POSITIVE] Perfect. Thank you so much, [PII]. Have a great day.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. You have a great one as well. Bye bye.
[CUSTOMER][POSITIVE] Thank you bye take care.