AccountId: 011433970860
ContactId: b8796e1a-e7be-49cb-93aa-0e4b62c20406
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 152570 ms
Total Talk Time (AGENT): 84020 ms
Total Talk Time (CUSTOMER): 45571 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=2.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/19/b8796e1a-e7be-49cb-93aa-0e4b62c20406_20250319T18:17_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, yes, I'm calling for benefits and eligibility please for one of our patients.
[AGENT][POSITIVE] Sure, I'll be more than happy to help you with both the eligibility and the benefits. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, of course. It's gonna be [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And may I have the member's policy number?
[CUSTOMER][POSITIVE] Yes, of course.
[CUSTOMER][NEUTRAL] The member's policy number is gonna be 01611546 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] Thank you. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes, of course, it's gonna be [PII], [PII] [PII] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And I do see the policy is active, and it's been effective since [PII].
[AGENT][NEUTRAL] And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] An office visit and outpatient surgery.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So, for the outpatient surgery, the outpatient benefit is up to $1500 per calendar year. Um, did you want me to see if any of that has been used?
[CUSTOMER][NEUTRAL] Yes, 1500.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] And let me see let me see. So so far for [PII], um, none of the balance has been used, so she still has that full 1500, sorry, he, and then in terms of the office visit, so the policy itself doesn't have like
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] In-off coverage for the facility charge, but they have the office treatment rider added to the policy. So any treatment in the office as long as it's not cosmetic, could be covered up to that um $1500 per calendar year.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] And a reference number?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] OK, perfect. Thank you so much. You have a great rest of your day, OK?
[AGENT][POSITIVE] Thank you, [PII]. Was there anything else I could assist you with today?
[CUSTOMER][POSITIVE] No, thank you so much.
[AGENT][POSITIVE] Alright, thanks for calling APL. You're welcome. Have a great day.
[CUSTOMER][NEUTRAL] You too.