AccountId: 011433970860
ContactId: cf4cbae5-7170-415e-bfb8-fffdcf1db03e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 136990 ms
Total Talk Time (AGENT): 68590 ms
Total Talk Time (CUSTOMER): 47619 ms
Interruptions: 1
Overall Sentiment: AGENT=1.4, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/cf4cbae5-7170-415e-bfb8-fffdcf1db03e_20250416T15:15_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, I'm calling to verify benefits and eligibility on a patient.
[AGENT][POSITIVE] Sure, I can assist you with that. Can I have your name and a callback number?
[CUSTOMER][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And the phone number is [PII]?
[AGENT][NEUTRAL] Thank you [PII]. What is the policy number of the member that you're calling to check eligibility for?
[CUSTOMER][NEUTRAL] Um, sure, it's 01261895.
[AGENT][NEUTRAL] Verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Calling to verify benefits and eligibility for what place of service?
[CUSTOMER][NEUTRAL] For medical, uh, specialist office.
[AGENT][NEUTRAL] This policy has been active since [PII] and it's currently active.
[CUSTOMER][NEUTRAL] OK, um, does this cover, um, any of the specialist on this call?
[AGENT][NEUTRAL] Office visits are not covered, no, unfortunately it does not cover office visits, it only covers inpatient and outpatient services.
[CUSTOMER][NEUTRAL] For the hospital?
[AGENT][NEUTRAL] Inpatient is for the hospital, 18 hours or more. Outpatient is considered as diagnostic testing, physical therapy. Anything considered as place of service 23.
[AGENT][NEUTRAL] Or 22.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Or 19.
[CUSTOMER][NEUTRAL] OK, um, so if since we do X-rays here in the office, is that considered, is that covered or no?
[AGENT][NEUTRAL] That's not covered, uh, office visit or not, it's not covered. Is it considered as an urgent care or diagnostic setting, diagnostic testing setting or physical therapy?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] So we won't be covered unfortunately. Can I get your name again if you don't mind?
[CUSTOMER][NEUTRAL] Mm mm.
[CUSTOMER][NEUTRAL] Sure [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] I was gonna call you've been there for.
[CUSTOMER][NEUTRAL] And what was your name?
[AGENT][NEUTRAL] [PII] and today's date is a reference, [PII].
[CUSTOMER][POSITIVE] OK, thank you very much.
[AGENT][POSITIVE] You're welcome, thanks for calling APL. Have a great day.
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][POSITIVE] Thanks, goodbye.
[CUSTOMER][NEUTRAL] Bye bye.