AccountId: 011433970860
ContactId: c044c8bd-d80e-44a9-ab3b-e90875ebb265
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 175789 ms
Total Talk Time (AGENT): 92168 ms
Total Talk Time (CUSTOMER): 58433 ms
Interruptions: 0
Overall Sentiment: AGENT=2.6, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/c044c8bd-d80e-44a9-ab3b-e90875ebb265_20250429T14:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Good morning how are you?
[AGENT][POSITIVE] I'm good. How are you?
[CUSTOMER][POSITIVE] I'm good. I'm calling to get benefits and eligibility for a member, please.
[AGENT][POSITIVE] All right. Happy to check on benefits and eligibility. What's the policy number?
[CUSTOMER][NEUTRAL] Yes, it is 0212.
[CUSTOMER][NEUTRAL] 33
[CUSTOMER][NEUTRAL] 79.
[AGENT][POSITIVE] Thank you. And if you don't mind, can I grab your first name and a callback number, please?
[CUSTOMER][NEUTRAL] Of course it's [PII].
[CUSTOMER][NEUTRAL] And it's [PII]?
[AGENT][NEUTRAL] Thank you, [PII]. And then what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] The name is [PII] and the date of birth is [PII].
[AGENT][POSITIVE] Thank you so much. So patient is active. Effective date on here is [PII], and we are the members secondary insurance. So this is gonna cover deductible, co-pay, co-insurance, the primary does not.
[CUSTOMER][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] So it would cover like office um procedures and stuff?
[AGENT][NEUTRAL] Mhm, exactly, it does have a limit if you're looking for outpatient, it looks like their outpatient benefit amount for the year would be $2000 max.
[CUSTOMER][NEUTRAL] OK, so that's not including the visit, just the procedures, correct?
[AGENT][POSITIVE] Just right office treatment, correct, yes. Uh-huh.
[CUSTOMER][NEUTRAL] OK, OK, hold on, I guess I have to write all this down. Give me one second.
[AGENT][POSITIVE] No worries.
[CUSTOMER][NEUTRAL] Sorry.
[AGENT][NEUTRAL] No, no, don't apologize.
[CUSTOMER][NEUTRAL] OK, so this covers up to you said 25?
[AGENT][NEUTRAL] Um, 2000.
[CUSTOMER][NEUTRAL] 2000. OK, and have they used anything?
[AGENT][NEUTRAL] It looks like they have um they've used 26933, so that looks like the remaining balance for the year is $1730.67.
[CUSTOMER][POSITIVE] Perfect. And then for the office visit, does it, how much does that cover or that's unlimited?
[AGENT][NEUTRAL] So it covers up to the 2000 amount it's not gonna pay over that, um, so as long as they have money still available like it would cover treatment in office.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK perfect. OK, that was all if you could just provide me a reference for the call.
[AGENT][NEUTRAL] Yeah, absolutely. [PII], it's my name with my last initial then today's date. My name is [PII], which [PII] [PII] is [PII] and then today's date.
[CUSTOMER][POSITIVE] OK perfect thank you so much you have a good day OK?
[AGENT][NEUTRAL] You too bye bye.