AccountId: 011433970860
ContactId: b4506146-224f-4b6d-80d4-89bf610a0930
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 177059 ms
Total Talk Time (AGENT): 68650 ms
Total Talk Time (CUSTOMER): 81945 ms
Interruptions: 2
Overall Sentiment: AGENT=1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/b4506146-224f-4b6d-80d4-89bf610a0930_20250207T17:32_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII], I'm trying to get some benefits information.
[AGENT][NEUTRAL] OK, may I have your name? I can help you?
[CUSTOMER][NEUTRAL] My name is [PII]. The ID number is [PII].
[AGENT][NEUTRAL] And [PII], what is your callback number if we are disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, one moment please, let me get that policy number pulled up.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you and verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] of
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] OK, thank you very much for that information. I have it pulled up and you're calling for outpatient benefits or inpatient?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Outpatient
[AGENT][NEUTRAL] OK, one moment please.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And the patient shows an effective date of [PII] and it shows active. Please note verification of benefits provided does not guarantee payment. We pay up to $4000 for the calendar year. She does have a $250 deductible.
[CUSTOMER][NEUTRAL] Yep
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, the plan does cover it for a physician's office visit.
[CUSTOMER][NEUTRAL] the same.
[CUSTOMER][NEUTRAL] OK, shows $250 deductible. Anything met yet for that?
[AGENT][NEUTRAL] OK, let me check that.
[CUSTOMER][NEUTRAL] Let me check that.
[AGENT][NEUTRAL] Not for [PII].
[CUSTOMER][NEUTRAL] Not for 23.
[CUSTOMER][NEUTRAL] OK, is there an office visit?
[CUSTOMER][NEUTRAL] Payment or no?
[AGENT][NEUTRAL] We pay for an office visit and that benefit is up to 25.
[CUSTOMER][NEUTRAL] We pay for you pay for.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is there a
[CUSTOMER][NEUTRAL] An amount of offices that she can have a year that you guys will pay for?
[AGENT][NEUTRAL] The limit, yes, she has 4.
[CUSTOMER][NEUTRAL] Limit, yes, uh huh. 4 for a year.
[CUSTOMER][NEUTRAL] Probably none of them have been met. Um, and how about for surgery?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Outpatient surgery.
[AGENT][NEUTRAL] Is that
[AGENT][NEUTRAL] Um, that falls under the 4000 for the year.
[CUSTOMER][NEUTRAL] Um, that falls on the.
[CUSTOMER][NEUTRAL] And she hasn't met any of that either.
[AGENT][POSITIVE] Correct, she hasn't used anything.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] Any pre-certs required or you just follow the primary?
[AGENT][NEUTRAL] No pres starts or pre-authorization are required.
[CUSTOMER][NEUTRAL] No pre research.
[CUSTOMER][POSITIVE] Oh, that's all I need. Thank you so much. Can I have a reference number please?
[AGENT][POSITIVE] You're welcome, [PII]. We did not use reference numbers. You, you can use my name [PII] last initial [PII], and today's date and we thank you for calling this APL. Have a great weekend.
[CUSTOMER][NEUTRAL] That use reference.
[CUSTOMER][POSITIVE] Thank you, uh huh bye bye.
[AGENT][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Bye.