AccountId: 011433970860
ContactId: b8878ef4-08ed-4d66-9264-ca1652fff8a1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 250580 ms
Total Talk Time (AGENT): 117089 ms
Total Talk Time (CUSTOMER): 76110 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/b8878ef4-08ed-4d66-9264-ca1652fff8a1_20250304T18:22_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, yes, I'm calling for benefits and eligibility please for one of our patients.
[AGENT][NEUTRAL] Sure, I can assist you with benefits and eligibility. And may I have your name?
[CUSTOMER][NEUTRAL] Yes, it's gonna be [PII].
[AGENT][NEUTRAL] OK. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. And do you have an extension number, Ms. [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] and you're calling from which facility for my notation.
[CUSTOMER][NEUTRAL] South Florida EMC associates.
[AGENT][NEUTRAL] OK. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, it's gonna be 26091.
[AGENT][NEUTRAL] Is that all the numbers you have or do you have the policy certificate?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] That is the numbers that I do have. I can check the patient's account to see if maybe they put they scan the patient's card.
[CUSTOMER][NEUTRAL] But the number that the patient provided with that. Give me one moment.
[AGENT][NEUTRAL] If you don't mind.
[AGENT][NEUTRAL] Mhm. Yeah, because that number, it looks like it may be a group number if I'm not mistaken, but it's not a policy number.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Let me check with the computer.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] If you don't have it, just let me know and just give me the name of the patient.
[CUSTOMER][NEUTRAL] I do not, yeah, I do not have it. That's the number that the patient provided. The patient's name is gonna be [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, thank you, thank you. All right, um, I found it and you say you need benefits and eligibility, and this is gonna be for outpatient benefits, uh, office setting.
[CUSTOMER][NEUTRAL] Yes, an office visit if you guys um cover that as well.
[AGENT][NEUTRAL] OK. Well, before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. And this is one of our secondary supplemental plans to the major medical. Let me start off by giving you the policy number. Let me know when you're ready.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Please, I am ready.
[AGENT][NEUTRAL] OK, the policy number is 0241.
[AGENT][NEUTRAL] 943 2.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] You're welcome. Effective date is [PII]. It is active at the moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And again this is a secondary supplemental plan and we have a calendar year maximum of 1000. This includes the office treatments, but it does not include the office visit, um.
[AGENT][NEUTRAL] Yeah, office visits are not covered. It's just gonna be for office procedures only.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Oh, no.
[CUSTOMER][NEUTRAL] OK, so it's not covered and it's up to 1000. How much has it been accumulated for this year?
[AGENT][NEUTRAL] Let me see
[AGENT][NEUTRAL] As of today, he has not used his benefits, so he still have the full amount available.
[CUSTOMER][NEUTRAL] OK perfect and you said your name is?
[AGENT][NEUTRAL] My name is [PII]. That's [PII].
[CUSTOMER][NEUTRAL] Perfect, and that would be your reference number with today's date, correct?
[AGENT][POSITIVE] Correct, yes.
[CUSTOMER][POSITIVE] Perfect thank you so much you have a great rest of your day OK?
[AGENT][POSITIVE] You're welcome. [PII], and thank you for calling APO.
[CUSTOMER][POSITIVE] Alrighty bye