AccountId: 011433970860
ContactId: 9fd4f752-d2bd-48d7-8796-a4fe2ad153cc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 163440 ms
Total Talk Time (AGENT): 81771 ms
Total Talk Time (CUSTOMER): 80101 ms
Interruptions: 4
Overall Sentiment: AGENT=1.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/17/9fd4f752-d2bd-48d7-8796-a4fe2ad153cc_20250317T14:47_UTC.wav
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[AGENT][POSITIVE] Thank you for calling. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Oh wait, let me double check something else. I'm gonna be.
[CUSTOMER][NEUTRAL] That day.
[CUSTOMER][NEUTRAL] I'm sorry, what did you say your name was?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] Hi, [PII], my name is [PII]. Um, I am calling from back pain center.
[CUSTOMER][NEUTRAL] And um I am just trying uh to get chiropractic benefits and eligibility for a patient, please.
[AGENT][POSITIVE] Alright, I'm happy to check benefits, [PII]. What's the policy number?
[CUSTOMER][NEUTRAL] Yeah, it is 021-922-67.
[AGENT][NEUTRAL] Alright thank you let me just pull this up here one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And then if I can get the patient's uh name and date of birth?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Sure, um, it's [PII] [PII].
[AGENT][NEUTRAL] Alright, thank you so much. So the patient is active. The effective date if you need that is [PII]. We're the secondary insurance, so this covers deductible, co-pay, co-insurance that the primary does not. The outpatient benefits for the calendar year are 3500.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] I can do that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me come back.
[CUSTOMER][NEUTRAL] And um.
[AGENT][NEUTRAL] And let me see what they've used for the year here.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Uh, looks like they have not used anything for the year.
[CUSTOMER][NEUTRAL] OK, um, so does it cover any chiropractic or just whatever the primary doesn't cover we then submit to you, um, or.
[AGENT][NEUTRAL] Correct, yeah, so the only thing that this is not gonna cover so it would cover any sort of treatment, but it's not gonna cover the office visit fee. So if the member has like a office visit copay with their primary then that would be due because we're not gonna cover that.
[CUSTOMER][NEUTRAL] I have [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Alright, OK.
[CUSTOMER][NEUTRAL] So 7 cents today.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] And then is there a visit limit?
[AGENT][NEUTRAL] There is not just the dollar amount.
[CUSTOMER][NEUTRAL] OK, just the $3500 amount?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK perfect can I get a reference number please?
[AGENT][NEUTRAL] Absolutely. Call references my name with my last initial than today's date. My name again is [PII], that's [PII] Last initial is [PII].
[CUSTOMER][POSITIVE] Perfect thank you so much sir you have a wonderful Monday.
[AGENT][POSITIVE] You too, [PII]. Take care.
[CUSTOMER][NEUTRAL] Mhm bye.
[AGENT][NEUTRAL] Bye.