AccountId: 011433970860
ContactId: c9466c55-bde1-439e-98f9-316f8dd93476
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 150899 ms
Total Talk Time (AGENT): 51170 ms
Total Talk Time (CUSTOMER): 61922 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/02/c9466c55-bde1-439e-98f9-316f8dd93476_20250502T15:33_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] calling from Texas Digestive Specialist. I was calling to verify um eligibility and the accumulations for a patient.
[AGENT][NEUTRAL] OK. Do you have the policy number or can I get a good callback number first?
[CUSTOMER][NEUTRAL] Yes, [PII] and I am at extension [PII].
[AGENT][NEUTRAL] OK, thank you, [PII], and I can help you with that eligibility and uh benefits. Uh do you have a policy number?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] It's gonna be 02243512.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] It's gonna be [PII]. Date of birth [PII].
[AGENT][NEUTRAL] OK, it looks like her policy is effective [PII]. It's currently active.
[AGENT][NEUTRAL] And you said you needed accumulations, is that right?
[CUSTOMER][NEUTRAL] Mm yes um just to clarify first though this policy is for outpatient services, um, mainly correct or inpatient and outpatient.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] And then um what would be the maximum that the plan pays?
[AGENT][NEUTRAL] Look up maximum. This is not a guarantee of payment. It's a basic outline of a policy.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Um, for outpatient services it's 2550 per calendar year per covered person maximum.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] And then um.
[CUSTOMER][NEUTRAL] If I could just have the accumulation now.
[AGENT][NEUTRAL] Uh, let me see if she's met anything.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Like she's used 1,110106, so 1101.06.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][POSITIVE] Alrighty thank you so much for that um I appreciate it if I could just please have a reference number.
[AGENT][NEUTRAL] That's my name, [PII], first initial to last name, [PII], and today's date.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you so much [PII] have a good day.
[AGENT][POSITIVE] Thank you for calling APLU as well. Bye-bye.
[CUSTOMER][POSITIVE] Thank you bye bye.