AccountId: 011433970860
ContactId: b20a9884-909a-466c-9083-8632044e02aa
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 161429 ms
Total Talk Time (AGENT): 71068 ms
Total Talk Time (CUSTOMER): 52087 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/b20a9884-909a-466c-9083-8632044e02aa_20250203T13:55_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. My name is [PII]. I'm calling from a provider's office. I just need help in checking eligibility and benefits of one of our patients, please.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the eligibility and benefits. And then may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Uh, contact number [PII].
[CUSTOMER][NEUTRAL] And policy policy ID 02509831.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's [PII], [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. I am showing that the policy is active, it's been effective since [PII]. And did you want to go over outpatient benefits today?
[CUSTOMER][NEUTRAL] Um, for inpatient office visits, specialist office visit.
[AGENT][NEUTRAL] OK, so the policy will pay up to $8700 per person per calendar year.
[AGENT][NEUTRAL] Um, and that does include um treatment in the physician office, which includes the specialist.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Does that include the office visit or just the treatment procedures?
[AGENT][NEUTRAL] So the facility, if you charge for a facility charge, that, that wouldn't be covered. There's treatment in the office that's covered. Um, so it would be the treatment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Are there copays, deductibles, or?
[AGENT][NEUTRAL] Um, not for the secondary insurance. If primary applies those, we help pay that.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] All right. Thank you so much. That's all I need to know. Can I have a reference number for this call?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. So again, that's [PII] in today's date.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Alright, thank you so much, [PII]. Have a great day. Bye for now.
[AGENT][POSITIVE] You also and thanks for calling APL. Bye-bye.