AccountId: 011433970860
ContactId: a235c148-c5b7-4210-9b8a-b8134e76e6df
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 326359 ms
Total Talk Time (AGENT): 93689 ms
Total Talk Time (CUSTOMER): 59507 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/a235c148-c5b7-4210-9b8a-b8134e76e6df_20250306T18:51_UTC.wav
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[AGENT][NEUTRAL] UPL this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, uh, this is [PII] calling from doctor office. I have a patient. I want to check the eligibility and benefits.
[AGENT][NEUTRAL] OK, I didn't understand your name.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK. That's [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, and you said you're wanting to check eligibility and benefits. Is this service in a doctor's office?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, and what's the policy number, [PII]?
[CUSTOMER][NEUTRAL] 0241
[CUSTOMER][NEUTRAL] 5285 ML 8.
[AGENT][NEUTRAL] And what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, give me that one more time, please.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] And [PII], can you verify the patient's name and date of birth for me?
[CUSTOMER][NEUTRAL] Yes, uh, patient name is [PII]. Date of birth date of birth number.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you. So I'm showing the effective date.
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Uh, the policy is active at this time.
[AGENT][NEUTRAL] And for the office visit?
[AGENT][NEUTRAL] Uh, the office visit fee is not covered.
[AGENT][NEUTRAL] Um, under this policy?
[AGENT][NEUTRAL] Uh, there is a, excuse me, there is a treatment writer, which means it covered treatment is performed in the office, uh, those items can be considered under the outpatient benefit.
[CUSTOMER][NEUTRAL] Mhm. Can you, can you please provide me the benefits amount out of pocket?
[AGENT][NEUTRAL] Mhm. So for covered.
[AGENT][NEUTRAL] So for covered treatment in the office, the maximum outpatient benefit.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] It's up to $400 per calendar day.
[AGENT][NEUTRAL] And any information provided today is verification only, not a guarantee of payment?
[AGENT][NEUTRAL] And did you have any
[CUSTOMER][NEUTRAL] OK, how much?
[AGENT][NEUTRAL] It's up to $400 per calendar day.
[CUSTOMER][NEUTRAL] $400 per day.
[AGENT][NEUTRAL] That's for outpatients, that's the outpatient benefit. So if there's treatment in the office, it'll fall under that benefit up to $400 per calendar day.
[CUSTOMER][NEUTRAL] OK, for they are eligible for $400 for office, uh, services.
[CUSTOMER][NEUTRAL] For outpatient.
[AGENT][NEUTRAL] Treatment in the office.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, give me the call reference number.
[AGENT][NEUTRAL] Any other questions?
[AGENT][NEUTRAL] Did you have any other questions?
[CUSTOMER][NEGATIVE] No thanks for giving me a call.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No thank you. Give me the yeah, give me the card reference number.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Please.
[AGENT][NEUTRAL] You'll use my name in today's date as your reference. It's [PII].
[AGENT][NEUTRAL] [PII] first initial last name is [PII]. If no other questions, [PII], thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Take, take care.