AccountId: 011433970860
ContactId: cb69e226-ec00-4d11-b0b5-bc3785d15e0c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 231119 ms
Total Talk Time (AGENT): 141987 ms
Total Talk Time (CUSTOMER): 81412 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/cb69e226-ec00-4d11-b0b5-bc3785d15e0c_20250110T17:36_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. You're speaking with [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Good, um, oh, good afternoon, [PII]. My name is [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Um, I was wondering if you can help me with um benefits on this patient's plan to see what exactly it covers.
[AGENT][NEUTRAL] All right. [PII], what's your phone number just in case we disconnected?
[CUSTOMER][NEUTRAL] Of course [PII].
[AGENT][NEUTRAL] And you said [PII], right? Correct. I'm sorry if I call you [PII]. You said.
[CUSTOMER][NEUTRAL] Uh, no, no, it was right. [PII], [PII] is my daughter.
[AGENT][NEUTRAL] [PII], OK, OK. OK. Oh, ain't that something? But anyway, [PII], OK, thank you. Can I have the policy number that you're calling in reference to?
[CUSTOMER][NEUTRAL] It is
[CUSTOMER][NEUTRAL] Of course, the ID number on the card is policy 0245.
[CUSTOMER][NEUTRAL] 5570.
[AGENT][NEUTRAL] And that patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] All right. Thank you for that information. And you're calling for eligibility on this patient?
[CUSTOMER][NEUTRAL] Correct, just to see what it will cover of her of her primary insurance doesn't cover.
[AGENT][NEUTRAL] OK, now this policy you gave me, uh, terminated [PII]. Uh, let me see, did they, did she get another policy? Hold on one moment. I can see that she get another policy.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sometimes
[AGENT][NEUTRAL] OK, that's not it.
[AGENT][NEUTRAL] OK. 74. Let me try this one right here.
[CUSTOMER][NEUTRAL] Now
[CUSTOMER][NEUTRAL] OK they have their own.
[AGENT][NEUTRAL] OK. Now she do have a new policy effective [PII]. That policy number is 02583474.
[CUSTOMER][NEUTRAL] I did
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] OK, and this is her policy. It's a secondary policy and her benefits is based on what the primary applies towards the medical condition if it's a covered treatment on this policy, what is she's being treated for?
[CUSTOMER][NEUTRAL] Um, I have 3 CPT codes. She's gonna have a uh test done here in our office. I have CPT codes. I don't know if that'll help.
[AGENT][NEUTRAL] OK, so she's getting something inpatient?
[CUSTOMER][NEUTRAL] um, well, she's come as outpatient. She's gonna come get it done in the specialist of yeah.
[AGENT][NEUTRAL] That's what I'm talking about outpatient, but it's gonna be in a, it's gonna be in the doctor's office. Uh, let me get you, OK, let me get you over to that area so they can tell you exactly for sure with that particular treatment be covered cause I don't know since it's been done in a doctor's office. Would it be something that would be covered. But let me get you over to the just that does those. And [PII], I hope I can get you back. Uh, hold on one moment.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Of course.
[AGENT][NEUTRAL] OK, OK, yeah, I'm trying to get to where I can transfer you, but it don't look like I'm gonna be able to.
[AGENT][NEUTRAL] Transfer you to for some reason. Let me have your phone number. I got your phone number. Just let me uh reach out to them over there and I'm gonna give you a call back at [PII]. Is that correct?
[CUSTOMER][NEUTRAL] I just wanna do
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yes ma'am, and I'm option number 3.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Option 3, I'm gonna try to do it right now and call you right back, OK?
[CUSTOMER][POSITIVE] Perfect thank you so much I appreciate it.
[AGENT][POSITIVE] You're welcome, [PII]. Bye-bye.
[CUSTOMER][POSITIVE] Thanks bye bye.