AccountId: 011433970860
ContactId: d2b319c6-6681-43a9-8425-a3d5cb5e05fb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 198529 ms
Total Talk Time (AGENT): 109452 ms
Total Talk Time (CUSTOMER): 43482 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/d2b319c6-6681-43a9-8425-a3d5cb5e05fb_20250211T19:26_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I'm trying to get eligibility and benefits, please.
[AGENT][NEUTRAL] Your name?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK. [PII], I can barely hear you. Do you have me on speaker?
[CUSTOMER][NEUTRAL] Uh, no, I'm on a headset.
[AGENT][NEUTRAL] OK. And is this for service in a doctor's office?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. What's the policy number?
[CUSTOMER][NEUTRAL] 2550107
[AGENT][POSITIVE] And a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Thank you for that. So I'm showing the policy effective date is [PII] currently active at this time, and you said for an office visit benefit. Let me check the policy.
[AGENT][NEUTRAL] OK, so for service in a provider's office, the benefit is up to $50 per day.
[AGENT][NEUTRAL] A maximum of 4 days per calendar year.
[AGENT][NEUTRAL] Information provided is verification, not a guarantee of payment?
[AGENT][NEUTRAL] And for [PII] I do not show any of the visits used at this time.
[CUSTOMER][POSITIVE] Thank you. Could you also let me know for specialists and urgent care?
[AGENT][NEUTRAL] Yeah, so that's the same benefit for a specialist for urgent care. Uh, the benefit is $50 per day, uh, a maximum of 2 urgent care visits per calendar year.
[CUSTOMER][NEUTRAL] OK thank you and do they use the network with their plans?
[AGENT][NEUTRAL] Uh, let me verify.
[AGENT][NEUTRAL] I'm showing the PPO network of contracted providers is multi-plan. Are you familiar with multi plan?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, that's the network.
[CUSTOMER][NEUTRAL] OK, thank you. Can I have the claims address and payer ID?
[AGENT][NEUTRAL] Uh-huh. It should also be on the identification card if you have it.
[AGENT][NEUTRAL] Um, the claim's mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the payer ID number is 64556.
[CUSTOMER][POSITIVE] Thank you. May I have the group number?
[AGENT][NEUTRAL] This number is also on the identification card. It's 70075.
[CUSTOMER][NEUTRAL] Yeah, I don't have that that's why I'm asking.
[AGENT][NEUTRAL] Yeah, I'm just saying when you get it it should be on there when they present to the office.
[CUSTOMER][NEUTRAL] When they present to the office, can I have a call reference number?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It'll be my name and today's date, [PII]. Any other questions?
[CUSTOMER][NEUTRAL] No, thank you.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.