AccountId: 011433970860
ContactId: 993c1e05-8cb8-4479-8fd5-2d1eac0a6c9a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 205210 ms
Total Talk Time (AGENT): 106421 ms
Total Talk Time (CUSTOMER): 76587 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/31/993c1e05-8cb8-4479-8fd5-2d1eac0a6c9a_20241231T19:12_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm calling from Eagle Landing OBGYN, and I need to see if I can get patient eligibility and benefits.
[AGENT][NEUTRAL] OK, I'm happy to check on eligibility and benefits today. What is the patient's policy number?
[CUSTOMER][NEUTRAL] 02569363
[AGENT][POSITIVE] All right, thank you so much for that. Let me just pull this up here one moment.
[AGENT][NEUTRAL] And if you don't mind, could I grab your first name and a callback number?
[CUSTOMER][NEUTRAL] Sure, my name is [PII] and the number is [PII].
[AGENT][POSITIVE] Thank you so much. So what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] Her date of birth is [PII].
[AGENT][NEUTRAL] All right, thank you for that. So I'm showing the patient's plan is active. The effective date on this is [PII].
[CUSTOMER][NEUTRAL] OK, so it starts on the [PII]. OK. All right, and do you have any uh benefits available?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, so for an office visit, this is a limited benefit plan, so it's gonna pay just a set amount depending upon what the patient's being seen for. This plan, it looks like allows the patient uh 6 office visits in a calendar year, and it's gonna pay a benefit amount of $75 towards the visit.
[CUSTOMER][NEUTRAL] OK, um, what about labs?
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Um, so it looks like imaging is showing a benefit amount of $200.
[AGENT][NEUTRAL] And it looks like it's a benefit of 2 per year.
[CUSTOMER][NEUTRAL] OK, um, but if she had blood drawn, any lab lab work done, is any labs covered?
[CUSTOMER][NEUTRAL] She was she was she's coming in to be tested, so I just wanna make sure.
[AGENT][NEUTRAL] Yeah,
[AGENT][NEUTRAL] Yeah, no, absolutely, so yeah, the lab coverage that I show would be just the benefit payment for the $200. It does cover labs.
[CUSTOMER][NEUTRAL] Oh, OK, OK, and um there's not any, uh, ACA coverage uh for her well woman's exam, I'm guessing, right?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, so it would just fall under, I believe like uh same as an office visit since that's what she was coming in for.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, that's what I thought. OK, well that's what I needed to know. I appreciate that. Could I just get a reference number?
[AGENT][NEUTRAL] Absolutely. Call reference is my name with my last initial and then today's date. My name again is [PII], that's spelled [PII] and the last initial to my name is [PII].
[CUSTOMER][POSITIVE] OK. Well, you enjoy the rest of your day, OK?
[AGENT][POSITIVE] You too, thanks for calling APL.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] Bye-bye.