AccountId: 011433970860
ContactId: 9d9520e3-fb3c-4b16-a977-67937976a77c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 218419 ms
Total Talk Time (AGENT): 89473 ms
Total Talk Time (CUSTOMER): 53674 ms
Interruptions: 1
Overall Sentiment: AGENT=1.6, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/02/9d9520e3-fb3c-4b16-a977-67937976a77c_20250602T20:25_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. I'm calling to verify benefits for a member.
[AGENT][POSITIVE] Yes, ma'am. I can assist you with benefits. Um first, could I get your name and a good callback number?
[CUSTOMER][NEUTRAL] Yes, my name is [PII], and a good call back is [PII].
[AGENT][NEUTRAL] OK, thank you, [PII]. Now, could I get the policy number, please?
[CUSTOMER][NEUTRAL] Yup. Uh, policy number is
[CUSTOMER][NEUTRAL] 026 03933
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Uh yeah. It's [PII], [PII].
[AGENT][NEUTRAL] OK, thank you. 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] and the policy is still active. Um, is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Uh, this is going to be for outpatient surgery in the hospital.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] I'm waiting for the benefits to come up. Please hold.
[CUSTOMER][POSITIVE] All righty.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Hm? Is he eating now?
[AGENT][POSITIVE] OK. Thank you, ma'am, for your patience.
[AGENT][NEUTRAL] Um, for outpatient, we cover up to 3000 per calendar year and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim.
[CUSTOMER][POSITIVE] All righty.
[CUSTOMER][NEUTRAL] Has the member used up this full benefit or is there anything remaining?
[AGENT][NEUTRAL] Oh, actually, she has. Yes, ma'am. She's used up the full 3000. She has no more outpatient benefits remaining.
[AGENT][NEUTRAL] For this year.
[CUSTOMER][POSITIVE] OK, perfect. All righty. Um, if I can just have your name again and a call reference number?
[AGENT][NEUTRAL] Um, yes, ma'am. For the reference number, you can use my name and today's date. My name is Evie. Um it's spelled E V I E. Last initial is M like Mary, and today's date. Um, is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] this
[CUSTOMER][NEUTRAL] I'm so sorry. I, I, I cut off. Can you repeat the call reference number?
[AGENT][NEUTRAL] Um yes, the reference number is my name and today's date. Um my name is Evie. It's spelled E V I E. Last initial is M like Mary and today's date. Um, is there anything else I can assist you with?
[CUSTOMER][POSITIVE] No, that's all. Thank you so much.
[AGENT][POSITIVE] OK, thank you, [PII], for calling APL. You have a great day. Mm bye.
[CUSTOMER][NEUTRAL] You too bye bye.