AccountId: 011433970860
ContactId: c9d3b7b2-f0c2-4287-be2a-530d9507c012
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 174570 ms
Total Talk Time (AGENT): 85342 ms
Total Talk Time (CUSTOMER): 62940 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/c9d3b7b2-f0c2-4287-be2a-530d9507c012_20250327T12:28_UTC.wav
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[CUSTOMER][NEUTRAL] I don't have a.
[AGENT][POSITIVE] Thank you for calling.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from Doctor [PII]'s office and I was calling to um get eligibility on a patient.
[AGENT][NEUTRAL] OK, I can help you, [PII]. What's the policy number and a good callback number?
[CUSTOMER][NEUTRAL] Yes ma'am, our telephone number is [PII] and policy number is 024744778.
[AGENT][NEUTRAL] Thank you. What's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] and her date of birth is [PII].
[AGENT][NEUTRAL] Alright, thanks for that information, [PII] and we're just checking eligibility dates.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Are we just checking eligibility dates?
[CUSTOMER][NEUTRAL] Uh, yes ma'am, and then just clarifying like um what if she has medical coverage for um prime like a primary care doctor's office and then your claims address.
[AGENT][NEUTRAL] OK, so you need the office visit benefit and then the claims mailing address as well.
[CUSTOMER][NEUTRAL] Yes, ma'am, please.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So I'm showing an effective date of [PII], and I do show the policy is active at this time. This is a Metlink policy which is secondary to the primary insurance and let me pull up the benefits and we'll provide that information if it's available.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] So under this policy, the physician visit fee is not covered, but there is a treatment writer, so covered treatment in an office can be considered under the outpatient benefit. Did you want that benefit?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] So the maximum outpatient benefit is up to $500 per calendar day for covered treatment and any information provided is verification only, it doesn't guarantee payment of a claim, and the physician visit fee is not covered.
[CUSTOMER][POSITIVE] Got you.
[AGENT][NEUTRAL] Any other questions?
[CUSTOMER][NEUTRAL] Um, let's see here, just, uh, claims address.
[AGENT][POSITIVE] Oh yeah, that's right
[AGENT][NEUTRAL] Um, it's [PII].
[AGENT][NEUTRAL] [PII] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] [PII], [PII].
[CUSTOMER][NEUTRAL] Re
[CUSTOMER][NEUTRAL] her she
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] It
[CUSTOMER][POSITIVE] Alright, perfect, that's what I needed.
[AGENT][NEUTRAL] All righty. Anything else?
[CUSTOMER][NEUTRAL] No ma'am, that's it.
[AGENT][POSITIVE] Alright, thank you for calling APL [PII] have a good day.
[CUSTOMER][POSITIVE] Thank you ma'am you too bye bye.