AccountId: 011433970860
ContactId: a4e78444-8714-43c6-b6c5-117d65880c59
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 147110 ms
Total Talk Time (AGENT): 88090 ms
Total Talk Time (CUSTOMER): 42518 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/a4e78444-8714-43c6-b6c5-117d65880c59_20250417T17:52_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I was calling to verify benefits and eligibility please.
[AGENT][NEUTRAL] Um, yes, ma'am. I can assist you with benefits. Um, first, could I get your name and a good callback number?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] My name is [PII] and it's [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, it is 02611536.
[AGENT][NEUTRAL] Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] It's [PII] and it's [PII].
[AGENT][NEUTRAL] And just let me advise you that verification of coverage does not guarantee payment of claims. The effective date on this policy was [PII]. The policy is still active, and is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Yes, uh, can I have all three, please?
[AGENT][NEUTRAL] OK, for inpatient, we cover up to 9500 per calendar year and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, for outpatient, we cover up to 6500 per calendar year.
[AGENT][NEUTRAL] And again, that's for the co-pay, co-insurance and deductible after primary insurance processes the claim. That's also the same benefit for office visits, except for the co-pay for office visits are not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, how about would office procedures be covered?
[AGENT][NEUTRAL] Um, yes, ma'am. That's covered, um.
[CUSTOMER][NEUTRAL] I'm sure it's yes, except for copays.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, of those amounts, how much is left, um, remaining?
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Um, she hasn't used any of her benefits this year, so it's all available.
[CUSTOMER][POSITIVE] Thank you so much. OK, and is there a reference number for this call?
[AGENT][NEUTRAL] Yes, you can use my name and today's date. My name is [PII]. It's spelled [PII] Last initial [PII] and today's date. Is there anything else I can assist you with?
[CUSTOMER][POSITIVE] No, that was it thank you so much.
[AGENT][POSITIVE] Thank you, [PII], for calling APL. Have a great rest of your day. Mm bye.
[CUSTOMER][NEUTRAL] You too bye bye.