AccountId: 011433970860
ContactId: 9fee111e-c071-4ff7-9372-9a04183a223d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 244970 ms
Total Talk Time (AGENT): 104708 ms
Total Talk Time (CUSTOMER): 103049 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/07/9fee111e-c071-4ff7-9372-9a04183a223d_20250507T20:46_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][POSITIVE] Hi um good afternoon [PII] I was calling to get eligibility and benefits for a patient.
[AGENT][NEUTRAL] OK, I can help you with eligibility and benefits. May I please get your name and your callback number and the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] I can help you with eligibility.
[CUSTOMER][NEUTRAL] Yes, my name is [PII]
[CUSTOMER][NEUTRAL] Um, I'm calling from asthma and allergy associated to Florida, and then the callback number is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And then, what is your
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I'm sorry, what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII], and then that member ID is [PII] [PII].
[AGENT][NEUTRAL] OK, let me look that up.
[CUSTOMER][NEUTRAL] Hm
[AGENT][POSITIVE] I do show that [PII] does have an active policy.
[CUSTOMER][NEUTRAL] I do show that
[AGENT][NEUTRAL] And the effective date of his policy is
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And everything is current on his policy and active.
[CUSTOMER][NEUTRAL] OK, and then um if I can get coverage for um, for a specialist offices it and then for allergy, um, skin testing injection and serum, see if they're covered.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, uh, and this is just to verify his benefits. It's not a guarantee of payment. This policy is a supplemental policy. It helps with deductible, co-pay and co-insurance only.
[CUSTOMER][NEUTRAL] policy
[CUSTOMER][NEUTRAL] Deductibles, co-pay and co.
[AGENT][NEUTRAL] And he has an outpatient calendar year benefit amount of $7350 and I'm gonna pull his policy up to see if he has office visits on this policy.
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][POSITIVE] OK, no problem.
[AGENT][NEUTRAL] And office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] And then have they met any to anything towards that um max limit?
[CUSTOMER][NEUTRAL] The 7350.
[AGENT][NEUTRAL] Let me check.
[AGENT][NEUTRAL] Let me check for you real quick.
[AGENT][NEUTRAL] They have used $166.95.
[CUSTOMER][NEUTRAL] OK, and then that would go, um, that would be good for the um the testing injection and serum or just the testing, the diagnostic?
[AGENT][NEUTRAL] It would be, it would be for deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] Portion.
[CUSTOMER][NEUTRAL] It would be it.
[CUSTOMER][NEUTRAL] OK, of the primary, right?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, alrighty, [PII], and then um if I can go ahead and just get the first initial to your last name and then just a reference number.
[AGENT][NEUTRAL] Yes, ma'am. Um, you spell my name [PII]
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Oh my
[AGENT][NEUTRAL] And then the last initial is [PII]
[AGENT][NEUTRAL] And then you can use um my name and today's date.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'm in today's day.
[AGENT][NEUTRAL] As your um reference number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK perfect alrighty sorry thank you so much.
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. Thank you for calling APL today and I hope you have a wonderful rest of your week.
[CUSTOMER][POSITIVE] You as well thank you so much bye bye.
[AGENT][NEUTRAL] Bye-bye.