AccountId: 011433970860
ContactId: 9f8e22bd-88a4-45e3-9f66-d341e19301f1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 194979 ms
Total Talk Time (AGENT): 97673 ms
Total Talk Time (CUSTOMER): 48149 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/2025/03/05/9f8e22bd-88a4-45e3-9f66-d341e19301f1_20250305T16:44_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is how may I assist you?
[CUSTOMER][NEUTRAL] Yes, hi, my name is [PII]. I'm calling from Doctor [PII]'s office. I'm just trying to verify eligibility, uh, for a member, please.
[AGENT][NEUTRAL] OK, sure. I can assist you with the eligibility, and I'm sorry, I didn't quite catch your name. Can you repeat your name?
[CUSTOMER][NEUTRAL] Yes, my name is [PII]
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, thank you. May I have a callback number just in case we get disconnected, Ms. [PII].
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] I have 01868782.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] This is for [PII] on [PII].
[AGENT][NEUTRAL] OK, and you just need eligibility.
[CUSTOMER][POSITIVE] Yes, eligibility and you can give me benefits for an offices or a specialist as well.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. All right. Um, we have an effective date of [PII]. It is active at the moment and this is one of our secondary supplemental plans to the major medical and the, and you said an office visit benefit?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Mm, OK, bear with me.
[AGENT][NEUTRAL] OK, one moment, let me pull the schedule benefits really quick on this one, OK?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright.
[AGENT][NEUTRAL] OK, and this is not a guarantee of payment, just a verification of coverage. And with this one is.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so this one does not cover the office visit. It will only cover if there's procedures in the office. So if there are procedures or treatment in the office, then that it will be subject to the outpatient maximum of 2550 per year.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But we do not cover the co-payment for the visit itself.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I see, so no, no office is it only the procedures.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And up to 2500 per year. Alright, well that's all I needed. Can I just get your name? I'm sorry.
[AGENT][NEUTRAL] Mhm. Yeah.
[AGENT][NEUTRAL] My name is [PII]. That's [PII].
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][POSITIVE] That's all you, you've been great helpful I appreciate it.
[AGENT][POSITIVE] You're welcome, Miss [PII]. Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Mhm you too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.