AccountId: 011433970860
ContactId: a5b32178-4228-4a46-9f4b-1683e57cc6be
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 150860 ms
Total Talk Time (AGENT): 76619 ms
Total Talk Time (CUSTOMER): 38314 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/02/a5b32178-4228-4a46-9f4b-1683e57cc6be_20250602T12:11_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII]. I'm calling from provider's office. How are you today?
[AGENT][POSITIVE] I'm good. How are you, [PII]?
[CUSTOMER][POSITIVE] I'm doing good thank you so much. I'm calling to get uh benefits and eligibility for a patient. I just wanna see the coverage.
[AGENT][POSITIVE] Um, yes, ma'am. I can assist you with benefits. And first, I'll need a good callback number just in case we're disconnected.
[CUSTOMER][NEUTRAL] Yes, it's gonna be [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. Thank you. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] It's gonna be 211.
[CUSTOMER][NEUTRAL] 0368.
[AGENT][NEUTRAL] Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Yes, patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you and just let me advise you that verification of coverage does not guarantee payment of claims. Um, 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] It's in office visit and you could do outpatient benefits as well.
[AGENT][NEUTRAL] OK, for outpatient benefits, we cover up to 500 per occurrence and every occurrence is every 90 days, and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim.
[AGENT][NEUTRAL] And for services provided in office, we cover up to $25 per visit and she gets 4 visits per calendar year.
[CUSTOMER][NEUTRAL] Alrighty and then how many visits has she met?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, so far she's used one.
[CUSTOMER][POSITIVE] Alrighty.
[AGENT][NEUTRAL] And is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] No, just the reference number.
[AGENT][NEUTRAL] OK. So the reference number, you can use my name and today's date. And again, my name is [PII]. Um it's spelled [PII] and my last initial is M like [PII] and today's date.
[CUSTOMER][POSITIVE] Perfect thank you so much have a great day.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL. Mm bye.
[CUSTOMER][NEUTRAL] Bye bye.