AccountId: 011433970860
ContactId: cb9a0518-852f-4f4b-a9c5-0efca2fb91c0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 174679 ms
Total Talk Time (AGENT): 85875 ms
Total Talk Time (CUSTOMER): 70963 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/24/cb9a0518-852f-4f4b-a9c5-0efca2fb91c0_20250424T19:08_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. My name is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] We
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Uh, hi [PII] I'm calling from a provider office. I need to verify patient eligibility and benefits.
[AGENT][NEUTRAL] OK, and what is your name, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you so much [PII] and your callback number please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And may I have the policy number?
[CUSTOMER][NEUTRAL] Uh yes, policy number is 02350081L.
[AGENT][POSITIVE] OK. Thank you very much. Let me just repeat that to you, please. I have that as 02350081ML8. OK, thank you.
[AGENT][NEUTRAL] Verify the member's name and date of birth.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh name [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Thank you very much for verification and you're calling to verify eligibility and benefits for outpatient, is that correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, I can assist you with both. Uh, the excuse me, the patient shows effective as of [PII]. This policy shows active as a supplemental medical and for outpatient benefits for this member, please note verification of benefits provided does not guarantee payment. We pay up to $2500 for the calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, question, do you cover the office visit copays?
[AGENT][NEUTRAL] OK. No, the policy does not cover all the physical copay.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK, that's what they want to know. So you mostly what you cover like uh testing, like procedures.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] It does, it also does not cover any services or procedures inside the doctor's office. It covers places of service such as an ER, urgent care, um, a hospital outpatient facility, diagnostic testing facility. Yes, ma'am.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] Yeah, I got it.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh, OK, I will write it down that. OK, in that case, may I have a reference number for the call, please?
[AGENT][NEUTRAL] OK. We do not provide reference numbers. You can use my name and today's date. And my last initial is L like Larry.
[CUSTOMER][NEUTRAL] OK, can I have your name again? I'm sorry.
[AGENT][NEUTRAL] Oh, no worries. My name is [PII].
[CUSTOMER][POSITIVE] [PII], yeah you say that and I already forget about that. [PII], thank you so much for your help.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a great day take care.
[CUSTOMER][POSITIVE] You too thanks same to you bye bye.
[AGENT][NEUTRAL] Bye.