AccountId: 011433970860
ContactId: b21cf13c-b734-4240-955e-0c859b9233c9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 204199 ms
Total Talk Time (AGENT): 63869 ms
Total Talk Time (CUSTOMER): 50806 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/b21cf13c-b734-4240-955e-0c859b9233c9_20250527T18:52_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from a special uh specialist doctor's office. I'm sorry, to see if I can get some eligibility and benefits.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Oh, are you there?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, sorry, I accidentally hit mute. Um, I can help you with those eligibility and benefits, [PII]. Um, do you have a good callback number?
[CUSTOMER][NEUTRAL] It's OK.
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And policy number for that patient?
[CUSTOMER][NEUTRAL] So all I have is 60801, is that correct?
[AGENT][NEUTRAL] Um, that's our payer ID. Uh, do you have the last name?
[CUSTOMER][NEUTRAL] Yes, I do. It's [PII], that's [PII]
[AGENT][NEUTRAL] OK, give me one moment.
[AGENT][NEUTRAL] Oh, running just a bit slow. Sorry about that. What's the first name?
[CUSTOMER][NEUTRAL] No, it's OK.
[CUSTOMER][NEUTRAL] His name is [PII].
[AGENT][NEUTRAL] OK, do you have his date of birth?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, thank you. Uh, I show this policy is active and effective [PII]. And are you needing outpatient benefits or?
[CUSTOMER][POSITIVE] Yes, he's coming to see a specialist.
[AGENT][NEUTRAL] I guarantee a payment outline of the policy.
[AGENT][NEUTRAL] Let me get that pulled up real quick.
[AGENT][NEUTRAL] So for his policy, he has a $400 per covered person per calendar day benefit payable, um, and that will be for treatments and procedures rendered in the office, just not the actual office visit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and then he is coming for just an office visit, so would there be a copay for that?
[AGENT][NEUTRAL] Um, no, they're just, it's a secondary policy, so it wouldn't have any coverage for just the office visit.
[CUSTOMER][NEUTRAL] OK, is there a way for me to give you our provider MPI and you tell me if we are in network with that?
[AGENT][NEUTRAL] Um, there's no network, um, because it's secondary, so they can see any provider they like.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Alrighty, OK, perfect. You said your name was [PII], right?
[AGENT][POSITIVE] Yes, that's right.
[CUSTOMER][POSITIVE] Perfect, thank you so much.
[AGENT][POSITIVE] Thanks for calling APL. Have a great day.