AccountId: 011433970860
ContactId: 99da6f54-0cf9-4c06-9406-5cf24e3128b9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 224889 ms
Total Talk Time (AGENT): 111632 ms
Total Talk Time (CUSTOMER): 57437 ms
Interruptions: 0
Overall Sentiment: AGENT=2.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/99da6f54-0cf9-4c06-9406-5cf24e3128b9_20250124T14:59_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] with Highland and Deonics. I was just calling to get um benefits on a patient of ours.
[AGENT][POSITIVE] Yeah, I'd love to help you with some benefits today, and you said your name was [PII]. Did I get that right?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Look [PII], I'm sorry about that.
[CUSTOMER][NEUTRAL] No, you're OK.
[AGENT][NEUTRAL] Do you mind if I go ahead and snag a quick call back number from you as well, Miss [PII]?
[CUSTOMER][NEUTRAL] Yeah it's [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what's that member's policy number?
[CUSTOMER][NEUTRAL] Um, it is.
[CUSTOMER][NEUTRAL] 01672696
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] You said we're needing eligibility and benefits, correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Perfect and I'm just getting that policy loaded for you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Oh goodness, I'm so sorry. Thanks for your patience, um.
[CUSTOMER][POSITIVE] Yeah you're OK.
[AGENT][NEUTRAL] There it is. Thank you so much. And uh would you be able to verify your patient's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] and her date of birth is [PII].
[AGENT][POSITIVE] Thank you very much. I do see [PII] here. She is current and active with an effective date of [PII].
[AGENT][NEUTRAL] And as far as benefits go, are you interested in just getting a fact back of benefits with the comprehensive breakdown?
[CUSTOMER][NEUTRAL] I just need her um maximum and the deductible.
[AGENT][NEUTRAL] OK, perfect. Let me get that pulled up for you. I do wanna let you know that any benefit information I give you over the phone is just a verification of coverage and never guarantee a payment.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] It looks like her calendar year maximum is $1250 and her deductible is $50. Um, it does look like the deductible does not apply to preventative.
[CUSTOMER][MIXED] OK, uh, but basically a major it does.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, um, does she have anything remaining on either one of those?
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Uh, let me take a look at what we've done for the calendar here. Hold on.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] All right, it looks for the calendar year that we still have that $50 deductible remaining and out of the calendar year maximum, we have $1110 remaining.
[CUSTOMER][NEUTRAL] Alright, that is all I need. Do you mind if I get a reference number?
[AGENT][NEUTRAL] You betcha. It's gonna be my name [PII], first initial, last name, [PII], and today's date. And is there anything else I can do for you, Ms. [PII]?
[CUSTOMER][NEUTRAL] That is it.
[AGENT][POSITIVE] Perfect. Well, thank you so much for calling APL and I hope you have a fabulous weekend.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][POSITIVE] Thanks. Bye bye.