AccountId: 011433970860
ContactId: c21c5dc1-2b1c-4837-b019-6f029c0aa54e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 226720 ms
Total Talk Time (AGENT): 123548 ms
Total Talk Time (CUSTOMER): 64398 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=2.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/c21c5dc1-2b1c-4837-b019-6f029c0aa54e_20250116T16:07_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Hi good morning I was calling to get eligibility and benefits, please.
[AGENT][POSITIVE] OK, yeah, I'd love to help you with some eligibility and benefits today and do you mind if I get a good name?
[CUSTOMER][NEUTRAL] Yes, my name's [PII].
[AGENT][POSITIVE] Thank you, Ms. [PII], and can I snag a quick callback number as well, please?
[CUSTOMER][NEUTRAL] Yes, that is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you and what's the member's policy number?
[CUSTOMER][NEUTRAL] That is 02544991.
[AGENT][NEUTRAL] Alright, 02544999139. Did I get that right?
[CUSTOMER][NEUTRAL] Um, I have, sorry, I have 02544991.
[AGENT][POSITIVE] 991. OK, perfect. Thank you so much. I'm sorry about that.
[CUSTOMER][NEUTRAL] You're fine.
[AGENT][NEUTRAL] And give me a second to get that policy pulled up for you, my friend.
[AGENT][NEUTRAL] Right. Thank you so much. And would you be able to verify for me, pretty please, your patient's first and last name and date of birth?
[CUSTOMER][NEUTRAL] That's [PII] [PII].
[AGENT][POSITIVE] Thank you so much. I do show Ms. [PII] right here. She is current and active in this policy. It looks like her effective date is [PII], no, I'm so sorry, [PII]. And you said you were needing benefits as well?
[CUSTOMER][NEUTRAL] Yes, please. I actually just needed to see if there was any co-pays um for a PCP specialist or urgent care visit please.
[AGENT][NEUTRAL] OK, absolutely. Let me pull up some uh benefit information. I do want to let you know anything I give you over the phone is just a verification of coverage and not a guarantee of payment.
[AGENT][NEUTRAL] Um, the policy she has with us doesn't have any co-pays. It is a limited supplemental policy, um, so it does have limited benefits for office visits. I do want to let you know it looks like she only has 4 office visits a year, um, with the benefit of $50 max per office visit.
[CUSTOMER][POSITIVE] OK, perfect. Thank you. Um, do they have a group number?
[AGENT][NEUTRAL] Mm.
[AGENT][POSITIVE] Yes, I can get that for you. Give me one second to pull it up.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Absolutely.
[AGENT][NEUTRAL] And it does look like her group number is 70075.
[CUSTOMER][NEUTRAL] And does she still have the multi-play network?
[AGENT][NEUTRAL] Uh, yes, she should still be in network with the multi plan.
[CUSTOMER][NEUTRAL] OK, I just have one more question and I'm done. Can I have the claims address and payer ID please?
[AGENT][NEUTRAL] You betcha. Um, the payer ID is 60801, and the address is, you can make it out to APL claims. It's gonna be [PII] and then that's in [PII], [PII].
[AGENT][NEUTRAL] Our zip code here is [PII].
[CUSTOMER][NEUTRAL] OK perfect and just to repeat that, that's payer ID 60801?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And then the [PII] [PII].
[AGENT][NEUTRAL] 248,950 you betcha.
[CUSTOMER][POSITIVE] OK, thank you so much. If I can just get a call reference number from you, please.
[AGENT][NEUTRAL] Yeah, you betcha. It's gonna be my name, [PII], and today's date.
[CUSTOMER][POSITIVE] OK. Thank you so much. You're very sweet. I appreciate it.
[AGENT][POSITIVE] Thank you Summer you have a great day and thanks for calling APL.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][NEUTRAL] Bye-bye.