AccountId: 011433970860
ContactId: a3cce88b-1e33-47e2-a3dc-de357e13efae
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 143470 ms
Total Talk Time (AGENT): 67192 ms
Total Talk Time (CUSTOMER): 80202 ms
Interruptions: 6
Overall Sentiment: AGENT=0.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/a3cce88b-1e33-47e2-a3dc-de357e13efae_20250213T15:31_UTC.wav
--------------------------------------------
[CUSTOMER][NEUTRAL] follow up.
[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hello, good morning. This is [PII]. I'm calling regarding a mutual member. I'm just trying to check the eligibility and benefits for it.
[AGENT][NEUTRAL] OK, do you have a phone number I can get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] Yes, [PII]. That'll be [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[AGENT][NEUTRAL] And the patient's name?
[CUSTOMER][NEUTRAL] And the
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you, [PII], and you were just needing benefits.
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] OK, I can help you with that. The effective date is [PII]. Any benefits given over the phone is not a guarantee of payment. Is this for outpatient, inpatient or doctor's office?
[CUSTOMER][NEUTRAL] Not a guarantee of payment, is it?
[CUSTOMER][NEUTRAL] It'll be for a doctor's office.
[AGENT][NEUTRAL] OK, is it for actual, is it for the actual office visit itself or is it for services?
[CUSTOMER][NEUTRAL] Specialist office.
[CUSTOMER][NEUTRAL] Is it for the actual
[CUSTOMER][NEUTRAL] Or is it
[CUSTOMER][NEUTRAL] It would be actually just for a regular office visit.
[AGENT][NEUTRAL] OK, office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, procedures done in the office.
[AGENT][NEUTRAL] Yes, ma'am, they, yes ma'am, those would be covered under their outpatient benefit, um, and this policy coordinates with the primary insurance.
[CUSTOMER][NEUTRAL] Those are?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Whatever the primary applies to their deductible co-pay or co-insurance we'll pick up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Up to $1500 per calendar year for services.
[CUSTOMER][NEUTRAL] $1500 per calendar.
[CUSTOMER][NEUTRAL] OK perfect sounds good and can I obtain a reference number for this call?
[AGENT][NEUTRAL] We do not have reference numbers. You can use my name in today's date. Is there anything else I can help you with?
[CUSTOMER][POSITIVE] No, that should be it thank you appreciate it.
[AGENT][POSITIVE] Thank you, [PII] for calling IPO. You have a good day.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.