AccountId: 011433970860
ContactId: c7b5e35a-8164-4e7c-9ed2-49051c0b7536
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 223970 ms
Total Talk Time (AGENT): 112498 ms
Total Talk Time (CUSTOMER): 56835 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=2.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/c7b5e35a-8164-4e7c-9ed2-49051c0b7536_20250326T20:56_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.
[AGENT][NEUTRAL] Sure, I can assist you with the eligibility and benefits. May I have your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Miss, may I have a callback number just in case we get disconnected.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sorry, that was [PII].
[CUSTOMER][POSITIVE] [PII], yes, correct.
[AGENT][NEUTRAL] Thank you. And may I have the name of the facility you're calling from, Ms. [PII]?
[CUSTOMER][NEUTRAL] South Florida EMT Associates.
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, the patient's policy number is gonna be.
[CUSTOMER][NEUTRAL] 01611569 M as in Mike L as in Lion, 8.
[AGENT][NEUTRAL] All right, thank you. And may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] The patient's name is gonna be Sherry A 830-71.
[AGENT][NEUTRAL] OK. Thank you. And uh so this is gonna be benefits for office setting specialists?
[CUSTOMER][NEUTRAL] It's gonna be an office visit and an outpatient surgery.
[AGENT][NEUTRAL] The outpatient surgery is gonna take place in the office or it's gonna be outpatient facility hospital?
[CUSTOMER][NEUTRAL] Then in the specialist office.
[AGENT][NEUTRAL] So everything is done in the office, OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] All right, and 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. We have an effective date of [PII]. It is active at the moment and this is one of our secondary supplemental plan to the major medical.
[AGENT][NEUTRAL] And with this one, we do cover office treatment or office procedures. It is subject to the outpatient maximum which is 1500 per covered person per calendar year.
[AGENT][NEUTRAL] Um, let me check and see if we cover the visit.
[AGENT][NEUTRAL] Mhm. No, it's just for the office treatment writer only, so it's the office treatment.
[CUSTOMER][NEUTRAL] So it's not for office visit, correct?
[AGENT][NEUTRAL] No, we do not cover the co-payment for the visit, so it's gonna be only for procedures.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect. And um how much has been accumulated?
[AGENT][NEUTRAL] OK, let me check on that.
[AGENT][NEUTRAL] OK, as of today, she has not used her benefits for [PII], so she still has her full amount available.
[CUSTOMER][POSITIVE] Perfect. And a reference number?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name and today's date if you would like.
[CUSTOMER][POSITIVE] Perfect. And what is, um, can you repeat your name, please?
[AGENT][NEUTRAL] Sure, that's all. That's [PII].
[CUSTOMER][POSITIVE] OK perfect.
[AGENT][NEUTRAL] Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] Thank you so much. You have a great rest of your day.
[AGENT][POSITIVE] You're welcome. You as well. Have a good afternoon. Bye-bye.
[CUSTOMER][NEGATIVE] No thank you.
[CUSTOMER][NEUTRAL] It's