AccountId: 011433970860
ContactId: b53403e2-635b-4efd-bae6-c694580f8934
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 383230 ms
Total Talk Time (AGENT): 136624 ms
Total Talk Time (CUSTOMER): 127211 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/b53403e2-635b-4efd-bae6-c694580f8934_20250228T19:20_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling you from Marymount Pediatric So check is some member have benefits for office visits and preventive care.
[AGENT][POSITIVE] It would be my pleasure to assist you, [PII]. What is the callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] Uh, let me see I close here. I'm sorry, um.
[CUSTOMER][NEUTRAL] Policy number is 02465901.
[AGENT][NEUTRAL] Thank you, [PII]. And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] Thank you. It'll be my pleasure to assist you with eligibility and benefits for [PII].
[AGENT][NEUTRAL] Excuse me, I apologize.
[AGENT][NEUTRAL] I'm checking to see.
[AGENT][NEUTRAL] Do you know when is the day of service in the future?
[CUSTOMER][NEUTRAL] Uh no, we saw this patient on [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] So the policy for [PII] was active um on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]. The effective date is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] When was the last time?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] The effective date was [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And bear with me just one second.
[AGENT][NEUTRAL] I apologize, bear with me just a second.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I'm checking the
[AGENT][NEUTRAL] Eligibility for [PII] again.
[AGENT][NEUTRAL] Now she was only covered for her newborn charges.
[AGENT][NEUTRAL] Is this for newborn charges?
[CUSTOMER][NEUTRAL] This one, yes, it was, uh, preventive care, I think it was 2, 2-week checkout. Let me see.
[AGENT][NEUTRAL] And your policy doesn't have preventive care. This policy pays towards sickness or injury.
[CUSTOMER][NEUTRAL] Only for injury?
[AGENT][NEUTRAL] Sickness or injury?
[CUSTOMER][NEUTRAL] OK, sickness and neck injury. OK.
[AGENT][NEUTRAL] Now, for her newborn hospital charges would be covered for newborn, but
[CUSTOMER][NEUTRAL] OK
[AGENT][NEGATIVE] Not for wellness.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Can I get um
[CUSTOMER][NEUTRAL] A reference number and can you help me with uh 2 more members?
[AGENT][NEUTRAL] I can bear with me just one second. Um, the reference number would be my name and today's date.
[AGENT][NEUTRAL] And I spell my name [PII]
[AGENT][NEUTRAL] First initial last name, [PII].
[CUSTOMER][NEUTRAL] You say LA I'm sorry, can you repeat your first name again?
[AGENT][NEUTRAL] Mhm. [PII] first initial of my last name is [PII].
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] OK, let me know when you're ready for the next one.
[AGENT][NEUTRAL] And
[AGENT][POSITIVE] All right. Thank you for your patience.
[AGENT][POSITIVE] [PII], I'm ready for the next policy.
[CUSTOMER][NEUTRAL] Oh, I think I already, OK, just give me one second, I think it's this one.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK, I have a policy number 02447297 and [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It is [PII], [PII].
[AGENT][POSITIVE] Alright, thank you, and I can help you with the eligibility for the lift.
[AGENT][NEUTRAL] I'm showing that the policy is active with the effective date of [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Anything else for you?
[CUSTOMER][NEUTRAL] Uh, yes, we saw her. I want to know if the member have benefits for office visits and preventing care. Mhm.
[AGENT][NEUTRAL] OK, I can
[AGENT][NEGATIVE] Now, preventive care is not covered under this plan. It would have to be for sick visit, but office visits are not covered.
[CUSTOMER][NEUTRAL] OK, sexless and injury also?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much. And I think I have a last one. Let me know, I think.
[AGENT][POSITIVE] I'm ready.
[CUSTOMER][POSITIVE] Uh, no, no, it was the last one. Thank you so much for your help.
[AGENT][POSITIVE] My pleasure to help you with that eligibility, [PII]. Thank you for calling APL and I hope you have a wonderful day. Happy weekend.
[CUSTOMER][POSITIVE] You too. Happy weekend too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.