AccountId: 011433970860
ContactId: ba792f16-22c2-448c-afe0-72fcbf710f6a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 251720 ms
Total Talk Time (AGENT): 86457 ms
Total Talk Time (CUSTOMER): 65008 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/04/ba792f16-22c2-448c-afe0-72fcbf710f6a_20250404T14:15_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling from a special uh from office provider's office. I just needed checking eligibility and benefits on one of our patients, please.
[AGENT][NEUTRAL] OK. Did you say [PII]?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, [PII], I can help you with benefits and eligibility. Do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Um, I have his card. I don't know which one is the policy number here. I'm seeing group number in hospital benefit, outpatient benefit.
[AGENT][NEUTRAL] Uh, you can give me the outpatient.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] So it's 02349881 M for Mary, L for Lima, 8.
[AGENT][NEUTRAL] And then do you have a good callback number, [PII]?
[CUSTOMER][NEUTRAL] Mhm. [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] What was the patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, it looks like this policy has termed, but he has another active policy. So let me get that pulled up.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, would you like the active policy number?
[CUSTOMER][POSITIVE] Ah yes, please.
[AGENT][NEUTRAL] Uh, that policy number is 2611599.
[AGENT][NEUTRAL] And let's see, so he is.
[AGENT][POSITIVE] He is active and effective for [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And do you need outpatient benefits?
[CUSTOMER][NEUTRAL] Yes, for a specialist office visit. And if it will cover the primary insurance co-pay.
[AGENT][NEUTRAL] Uh, let's see. So this is not a guarantee of payment. It's a basic outline of the policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Give me just a moment pulling it up.
[AGENT][NEUTRAL] Um, let's see.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] So he doesn't have benefits for the actual office visit, but any benefits um like treatments or procedures in the office would be covered, um, and that benefit is.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 3,575 per calendar year. So, um, basically it could pick up uh deductible or co-insurance up to 3,575.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] So just deductible and coinsurance.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Thank you so much. Can I have a reference number for this call, please?
[AGENT][NEUTRAL] Uh, reference number is just gonna be my first name, [PII], first initial to last name, [PII], and today's date.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] Alright, thank you so much for your help for today. Have a great day, [PII]. Bye for now.
[AGENT][POSITIVE] OK, thank you for calling APL you too.
[CUSTOMER][POSITIVE] Thank you.