AccountId: 011433970860
ContactId: a67a4b76-36bb-4eae-8c58-4e09e506157d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 159669 ms
Total Talk Time (AGENT): 77037 ms
Total Talk Time (CUSTOMER): 61647 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=2.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/11/a67a4b76-36bb-4eae-8c58-4e09e506157d_20250611T16:36_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hi, good morning. Uh, this is [PII]. I'm calling from um Cedar's Heart Clinic to verify eligibility and benefit.
[AGENT][POSITIVE] OK, yeah, I can check eligibility and benefits for you. And so, can I get a good call back number from you first in case we're disconnected please?
[CUSTOMER][NEUTRAL] Sure. Uh, that's [PII].
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Uh, one second. That's 1988266?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] This is for [PII], [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that. So this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays.
[AGENT][NEUTRAL] And we're we needing to look at uh inpatient or outpatient benefits for this member?
[CUSTOMER][NEUTRAL] This is for office visit, uh, specialist office visit.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Outpatient, so.
[AGENT][NEUTRAL] And of course, sure, and I will let you know verification of coverage is not a guarantee of payment for claims. So under this policy office visits are not covered. However, treatment received in office is, so if they were to receive any treatment in office that's covered the visit itself is not.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Oh, OK. So the office visit is not covered. How about, um, some procedures like X-rays, MRI, those ones?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Right, right. Treatment received in office is covered, yes, but the visits themselves are not.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK. OK. That's good to know. Um, the coverage date is [PII]. Is that right?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Of course.
[AGENT][POSITIVE] That's correct, yes.
[CUSTOMER][POSITIVE] Oh, OK, perfect. All right. Uh, I believe that's all I needed. Tell me your name again, please.
[AGENT][NEUTRAL] Uh, it's [PII]
[AGENT][NEUTRAL] Uh, was there anything else I could help you with?
[CUSTOMER][POSITIVE] [PII] OK, thank you so much sir.
[CUSTOMER][POSITIVE] Oh no, that's all. Thank you for your help. Have a great day.
[AGENT][POSITIVE] Alright, yeah, thanks for calling APL you too bye bye.
[CUSTOMER][POSITIVE] Thank you.