AccountId: 011433970860
ContactId: a799735d-4461-4796-808f-1179f15a234e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 251800 ms
Total Talk Time (AGENT): 121542 ms
Total Talk Time (CUSTOMER): 66485 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/30/a799735d-4461-4796-808f-1179f15a234e_20250530T16:50_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, I'm just calling to verify um a patient's insurance eligibility and benefits.
[AGENT][NEUTRAL] OK, you're needing eligibility and benefit information, is that correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] Yes, ma'am, I can help you with those things. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, [PII], thank you. And your callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and the member's policy number, please, [PII].
[CUSTOMER][NEUTRAL] It is 02587943. I'm actually trying to verify two people on this policy, OK.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] OK, and any information that I do provide for you would be a verification of benefits and not a guarantee of payment. What is the first patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] date of birth, hold on, uh, [PII].
[AGENT][NEUTRAL] What's the first name?
[AGENT][NEUTRAL] OK, what's the first name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I don't have a [PII].
[CUSTOMER][NEUTRAL] Let me make sure I got it right.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You call [PII].
[AGENT][NEUTRAL] OK. And then,
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And the other person?
[AGENT][NEUTRAL] Its name and date of birth?
[CUSTOMER][NEUTRAL] Uh, the other be a dependent and their name is [PII]. Date of birth [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII], one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and again, [PII], any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. So I do show that [PII] is the subscriber on this limited benefit plan.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And also the child is covered, and this policy is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what type of benefit information do you need for them?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Um, is there a maximum office visit, uh, office?
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][POSITIVE] Me, yeah, thank you, ma'am have a good one.
[AGENT][NEUTRAL] OK, so on this limited benefit plan for a physician's office visit, the benefit is $75 per day and a max of 6 days per calendar year per covered person.
[CUSTOMER][NEUTRAL] OK, per calendar year. OK, and can I get your name please?
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Again, my name is [PII]. First initial to my last name is [PII]. You would use my name along with today's date, Kaunda for your call reference number and if you won't end up submitting a claim for either of them on this coverage, once we've processed the claim, we do have a portal in which you should be able to check the claim status in by going to [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] Alright, well you're very welcome. So if that is all I can help you with, thank you again for calling APL and I hope you have a great weekend.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you, bye bye.