AccountId: 011433970860
ContactId: cd5ced76-2f28-4f03-bd6e-6431fa63fa36
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 176699 ms
Total Talk Time (AGENT): 81464 ms
Total Talk Time (CUSTOMER): 47166 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/18/cd5ced76-2f28-4f03-bd6e-6431fa63fa36_20250318T12:57_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling to check eligibility for one of my patients, please.
[AGENT][NEUTRAL] OK, well, I can definitely help you with the eligibility. And [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Uh yes. Phone number [PII].
[CUSTOMER][NEUTRAL] And then the policy number is
[CUSTOMER][NEUTRAL] 02255679.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. I am showing the policy is active. It's been effective since [PII].
[CUSTOMER][POSITIVE] Perfect. Uh, does this uh plan cover office visit co-payments?
[AGENT][NEUTRAL] So we do pay towards the copay, deductible and co-insurance of covered charges after primary. Let me see if this policy has office visits. Do you mind if I place you on just a brief hold?
[CUSTOMER][POSITIVE] No problem. Thank you.
[AGENT][NEUTRAL] All right. You're welcome. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, on base, what's going on?
[AGENT][NEUTRAL] What happened?
[AGENT][NEUTRAL] I don't see office treatment writer and I don't see.
[AGENT][NEUTRAL] That dependent child maternity, OK, no that's not it for sure.
[AGENT][NEUTRAL] I wanted to see it, but I don't see it on here, so it's OK.
[AGENT][NEUTRAL] Hello [PII].
[AGENT][NEUTRAL] Thank, thank you so much for holding. I apologize for that wait. So this, the secondary policy does not have any coverage for in-office setting or the treatment, so it does, it doesn't have the rider either.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, so no office setting, uh, like co-pays. How about for diagnosis testing in office? No?
[AGENT][NEUTRAL] Um, the policy doesn't cover anything in office. It would be inpatient or outpatient setting.
[CUSTOMER][NEUTRAL] In office.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect. Thank you so much, [PII], for your help.
[AGENT][POSITIVE] You're welcome. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] That's what I needed. Thank you so much.
[AGENT][POSITIVE] All right. Well, thanks for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank