AccountId: 011433970860
ContactId: a1345086-2960-4f1e-b827-5badb1421d30
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 330299 ms
Total Talk Time (AGENT): 107125 ms
Total Talk Time (CUSTOMER): 79776 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/08/a1345086-2960-4f1e-b827-5badb1421d30_20250508T21:00_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] I think I just
[AGENT][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Uh-huh, there is this I last my initial name is [PII].
[AGENT][NEUTRAL] OK, I, I missed your name. What was that?
[CUSTOMER][NEUTRAL] Can
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] [PII], OK, and you're with which provider?
[CUSTOMER][POSITIVE] Alright, the facility is Berre and wellness.
[AGENT][NEUTRAL] And you need a claim status?
[CUSTOMER][NEUTRAL] Uh, no, it is by eligibility.
[AGENT][NEUTRAL] Eligibility, OK.
[AGENT][NEUTRAL] And what do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Policy number for the patient?
[CUSTOMER][NEUTRAL] Sure, just a sec.
[CUSTOMER][NEUTRAL] It is 0256.
[CUSTOMER][NEUTRAL] 3602.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] It is for the member.
[CUSTOMER][NEUTRAL] Just a second.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the date of birth?
[CUSTOMER][NEUTRAL] The date of birth is [PII].
[AGENT][NEUTRAL] And you needed benefits for is this outpatient services or?
[CUSTOMER][NEUTRAL] Yes, outpatient services like uh medical benefits.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, this is not a guarantee of payment. It's a basic outline of the policy.
[AGENT][NEUTRAL] Um, let me see.
[AGENT][NEUTRAL] Um, so is there a specific benefit? Is it diagnostic testing or surgery or what type of benefit?
[CUSTOMER][NEUTRAL] Medicare.
[AGENT][NEUTRAL] Right, so is it like for
[AGENT][NEUTRAL] Uh, a hospital outpatient service like for surgery or diagnostic testing, do you know?
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yes, like all all outpatient services.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, so for surgery in a hospital, there's a benefit of $2000 per day.
[AGENT][NEUTRAL] Payable maximum one per calendar year.
[AGENT][NEUTRAL] Um, for emergency room.
[AGENT][NEUTRAL] 150 per day, payable.
[AGENT][NEUTRAL] Max of 2 days per year.
[CUSTOMER][NEUTRAL] So, can you please confirm the member's plan effective dates?
[AGENT][NEUTRAL] Effective date is [PII].
[CUSTOMER][NEUTRAL] And uh is there any termination date?
[AGENT][NEUTRAL] Uh, no, it's currently active.
[CUSTOMER][NEUTRAL] So for the medical benefits like uh physician visit, uh can you please confirm the pay ID for the member?
[AGENT][NEUTRAL] Your ID is 60801.
[CUSTOMER][NEUTRAL] You said 60801.
[AGENT][POSITIVE] Yes, correct.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Can you please confirm the mailing address for this?
[AGENT][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Yeah, it's [PII].
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] And uh the zip code?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Got it. Can you please spell out your first name and last name sir?
[AGENT][NEUTRAL] First name is [PII]. It's [PII] First initial to last name is [PII].
[CUSTOMER][NEUTRAL] And is there any call reference number?
[AGENT][NEUTRAL] Uh, my name is [PII], and today's date.
[CUSTOMER][POSITIVE] Have a nice day. Bye-bye.
[AGENT][POSITIVE] Thanks for calling