AccountId: 011433970860
ContactId: a340ebbf-a8c5-4798-9a7b-8ddb87b686ff
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 241630 ms
Total Talk Time (AGENT): 123404 ms
Total Talk Time (CUSTOMER): 63479 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/a340ebbf-a8c5-4798-9a7b-8ddb87b686ff_20250109T18:35_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Good afternoon. My name is [PII]. I'm calling from Doctor [PII]'s office. I'm calling for benefits on a patient.
[AGENT][POSITIVE] OK, yeah, I'd love to help you with some benefits today and may I get a good callback number from you, Ms. [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Wonderful, thank you and then the member's policy number?
[CUSTOMER][NEUTRAL] It's 024.
[CUSTOMER][NEUTRAL] 77
[CUSTOMER][NEUTRAL] 09826401.
[AGENT][NEUTRAL] Alright. Unfortunately, I don't know if that's going to be a policy number with us. Ours is typically no more than 8 digits.
[AGENT][NEUTRAL] Um, do they have like a policy certificate number or another number on their card?
[CUSTOMER][NEUTRAL] I don't have the card, but, um, give me one second there's another number here 190755.
[AGENT][NEUTRAL] 190.
[AGENT][NEUTRAL] Sorry, I already typed it wrong. 755. Let me try that.
[CUSTOMER][NEUTRAL] 755.
[AGENT][NEGATIVE] Unfortunately that's not pulling anything up either, but I can always try searching by their first and last name as well.
[CUSTOMER][NEUTRAL] OK, the first name is [PII].
[CUSTOMER][NEUTRAL] The last name is [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, perfect. Give me a second to look that up.
[AGENT][NEUTRAL] And could you verify Ms. [PII]'s date of birth for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect. And let me get you that policy number if you're ready for it.
[CUSTOMER][NEUTRAL] OK, go ahead.
[AGENT][NEUTRAL] I have 02477098.
[CUSTOMER][NEUTRAL] OK, can you repeat that again? 02?
[AGENT][NEUTRAL] Yep, 02477098.
[CUSTOMER][NEUTRAL] And a group number do they have?
[AGENT][POSITIVE] Yeah, let me pull that up for you.
[AGENT][NEUTRAL] I have the group number is 26401.
[CUSTOMER][NEUTRAL] OK, and does it pick up for a specialist office visit like a co-pay or is it just a surgical plan?
[AGENT][NEUTRAL] Um, yeah, we're actually her gap insurance, so we pick up and pay on the co-pay, the co-insurance, the deductible for sickness or injury. Nothing routine here is covered and it looks like as far as office visits go.
[AGENT][NEUTRAL] Let me pull that up.
[AGENT][NEUTRAL] Her outpatient benefits are going to be, I'm so sorry, the screen is.
[AGENT][NEGATIVE] Not what I want. Um, her individual outpatient benefits are $7000 a year, granted, that's a guar uh verification of coverage and not a guarantee of payment.
[AGENT][NEUTRAL] And it
[AGENT][NEUTRAL] As far as physician's office, it looks like she has a cancer treatment in a physician's office, diagnostic testing in a physician's office, infusion therapy, kidney dialysis.
[AGENT][NEUTRAL] Occupational therapy.
[AGENT][NEUTRAL] Speech therapy, surgery.
[AGENT][NEUTRAL] Um,
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][POSITIVE] Uh thank you very much.
[AGENT][POSITIVE] Yeah, it's my pleasure, Miss [PII]. Is there anything else I can do for you today?
[CUSTOMER][NEUTRAL] That's it for today.
[AGENT][POSITIVE] Perfect. Well, you have such a wonderful day and thank you so much for calling APL. I hope you have a great time.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you.