AccountId: 011433970860
ContactId: b30b5382-0cd3-41fa-874c-8ff6aa89c999
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 147179 ms
Total Talk Time (AGENT): 71862 ms
Total Talk Time (CUSTOMER): 88955 ms
Interruptions: 4
Overall Sentiment: AGENT=1.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/b30b5382-0cd3-41fa-874c-8ff6aa89c999_20250121T16:01_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I wanted to check on eligibility and benefits for a member.
[AGENT][POSITIVE] Yeah, I could take eligibility and benefits for you. uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yes, it's [PII] and it's [PII].
[CUSTOMER][NEUTRAL] All right, now if you will initial and this is a release.
[AGENT][NEUTRAL] OK, thank you. And then did you have the policy number?
[CUSTOMER][NEUTRAL] Um, 02456442.
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEUTRAL] It looks like this is a secondary it looks like I guess I don't.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] [PII]. Date of birth [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. Uh, so this policy is active. Effective date was [PII], and yet this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays, and we're we need to look at outpatient benefit.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] for me again.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, uh huh.
[AGENT][NEUTRAL] OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims, so their outpatient benefit is on a per calendar day basis, so it is $500 max per calendar day.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] OK, that's kind of what I thought. I know she has a, she has another um type of insurance as well, so just kinda wanted to know when I was verifying it it was coming up that um.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] She was not found in our system when we were looking for it and I didn't uh it was rejecting her and I'm like well wait a minute I'm gonna find out if she's actually has the policy or not.
[AGENT][NEUTRAL] Oh,
[AGENT][NEUTRAL] Huh.
[AGENT][POSITIVE] Yeah, definitely.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK, alright, well that sounds good um, no, ma'am, is there any type of reference number I can put down?
[AGENT][NEUTRAL] Alright, was there anything else I can help you with?
[AGENT][NEUTRAL] It would just be my first name, last initial, and today's date. Uh so my name is spelled [PII]
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK all right well thank you very much I appreciate it.
[AGENT][POSITIVE] Yeah, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] You too thanks bye bye.
[AGENT][POSITIVE] Thanks bye bye.