AccountId: 011433970860
ContactId: b6784a08-b480-4ce1-aea2-6a7971b3ae36
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 147610 ms
Total Talk Time (AGENT): 62021 ms
Total Talk Time (CUSTOMER): 59103 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/29/b6784a08-b480-4ce1-aea2-6a7971b3ae36_20250129T22:22_UTC.wav
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[CUSTOMER][NEUTRAL] me tomorrow.
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, hi, [PII]. I'm calling from Doctor [PII]'s office. I need to go over a patient's gap plan.
[AGENT][NEUTRAL] Benefits or eligibility or both?
[CUSTOMER][NEUTRAL] Yeah, so benefits. I need to see if the patient has benefits with this gap plan because he has a deductible with his primary plan.
[AGENT][NEUTRAL] OK, and may I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] It's [PII] and that's [PII].
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Thank you for that and [PII], may I have the member's policy number?
[CUSTOMER][NEUTRAL] It's 01603031 ML8.
[AGENT][NEUTRAL] 01606031.
[CUSTOMER][NEUTRAL] No, 01603031 ML8.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] Thank you. Hold on one moment.
[AGENT][NEUTRAL] Alright, so this particular policy is no longer active as of [PII]. He does have an active policy. Um, I can give you that policy number when you're ready.
[CUSTOMER][POSITIVE] All right, I'm ready.
[AGENT][NEUTRAL] 254-496-4.
[CUSTOMER][NEUTRAL] I have here 254-496-4, OK?
[AGENT][POSITIVE] And hold on one moment, I'm pulling that up now to get those benefits for you. You're welcome.
[CUSTOMER][POSITIVE] And yeah, OK, thank you.
[AGENT][NEUTRAL] And this is for outpatient?
[CUSTOMER][NEUTRAL] Yes, since he has a deductible with his primary plan, yeah.
[AGENT][NEUTRAL] The
[AGENT][NEUTRAL] The policy would pay up to $1250 per calendar year for outpatient benefits.
[CUSTOMER][NEUTRAL] OK, so he does have benefits for outpatients, OK, and we're gonna submit claims to payer ID 60801.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] And his policy number is 2544964. OK, great. May I have a reference number for the call. Thank you.
[AGENT][NEUTRAL] Sure, no call reference number, just my name and today's date. The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] And your name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] All right great thank you bye bye.
[AGENT][POSITIVE] You're welcome, [PII]. Thanks for calling APO. Bye-bye.
[CUSTOMER][POSITIVE] Thanks bye. You're welcome bye.