AccountId: 011433970860
ContactId: a009d059-9978-41a0-b5f8-0d0b531f6cd2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 413140 ms
Total Talk Time (AGENT): 127959 ms
Total Talk Time (CUSTOMER): 147063 ms
Interruptions: 4
Overall Sentiment: AGENT=0.7, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/a009d059-9978-41a0-b5f8-0d0b531f6cd2_20250620T15:31_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] calling
[CUSTOMER][NEUTRAL] Hello, my name is [PII] and initial to my last name is [PII]. I'm calling from the provider's office.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, uh, what can we help you with today?
[CUSTOMER][NEUTRAL] I'm looking for the eligibility and benefits for specialist office visit.
[AGENT][NEUTRAL] OK, I could check those offices of benefits. um, and I, can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yup.
[CUSTOMER][NEUTRAL] [PII]. And the extension is [PII].
[AGENT][NEUTRAL] OK, thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Yep.
[CUSTOMER][NEUTRAL] 60801.
[AGENT][NEUTRAL] OK, so that's not one of our policy numbers, [PII], that is actually our payer ID. Do you maybe have their social I could search for them that way.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Give me a moment.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Can you please check with the member's name and the date of birth?
[AGENT][NEUTRAL] I wouldn't be able to use the date of birth, but I can try their name if you wouldn't mind spelling out the first and last name please.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] The member's last name is [PII] and the first name is [PII].
[AGENT][NEUTRAL] Could you spell out the first and last name please?
[CUSTOMER][NEUTRAL] The date of birth of this member is
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Last name is [PII]
[CUSTOMER][NEUTRAL] You got it?
[AGENT][NEUTRAL] Yes, and then the first name please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] And then what was the member's date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. I was able to locate their policy. Did you want me to go ahead and give you that correct policy number?
[CUSTOMER][NEUTRAL] Yup.
[AGENT][NEUTRAL] That is 0259.
[AGENT][NEUTRAL] 826 8.
[CUSTOMER][NEUTRAL] 02598268, right?
[AGENT][POSITIVE] Correct, this policy is active.
[AGENT][NEUTRAL] That effective date, uh, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That was uh [PII] and this is a secondary medical policy so it is designed to help with co-pay, deductible and co-insurance after major medical pays and if you'll give me one moment, I will check the benefits for an office visit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims under this policy office visits are not going to be covered, nor is treatment received in office.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well
[AGENT][NEUTRAL] Was there anything else I could help you with?
[CUSTOMER][POSITIVE] Thank you for coming
[CUSTOMER][NEUTRAL] Yeah. Can you please provide me information that which services are covered with the patient plan?
[AGENT][NEUTRAL] Could you repeat that?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I'm saying which kind of services are there in patient plan.
[AGENT][NEUTRAL] Inpatient?
[CUSTOMER][NEUTRAL] Outpatient.
[AGENT][NEUTRAL] Outpatient benefits or treatment in an uh hospital emergency room, urgent care, physical therapy performed in a physical therapy facility, surgery performed in a hospital outpatient facility or freestanding outpatient surgery center, diagnostic testing performed in a hospital outpatient facility or MRI facility, and treatment of mental or emotional disorder performed in a hospital outpatient facility.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] The end of you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much.
[CUSTOMER][NEUTRAL] Can you please spell your name for me?
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much. And then the last name?
[AGENT][NEUTRAL] Last initial is [PII]
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] OK. Thank you so much. Can you please provide me the call reference number?
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] Reference number would just be my first name, last initial and today's date.
[CUSTOMER][POSITIVE] OK, thank you so much, [PII], for providing the information. That's all I need for today.
[AGENT][POSITIVE] Of course, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] Goodbye. Have a wonderful day.
[AGENT][POSITIVE] Thank you you too bye bye.
[CUSTOMER][NEUTRAL] Bye bye.