AccountId: 011433970860
ContactId: d2d788d6-52c6-4a5e-83b9-1483f5468506
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 221429 ms
Total Talk Time (AGENT): 118157 ms
Total Talk Time (CUSTOMER): 47820 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/11/d2d788d6-52c6-4a5e-83b9-1483f5468506_20250411T20:09_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is how may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from Advanced Orthopedics of Oklahoma. I need to verify eligibility and benefits for a patient.
[AGENT][POSITIVE] Mhm, sure, I can assist you with eligibility and benefits. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, I have 01976096.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] All right. And may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yes, it's for [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, perfect. Thank you. All right, and let's see, before, um, let me see if I have a new policy. I'm sorry, this one is terminated.
[AGENT][NEUTRAL] Um, yeah, I do have one. Let me pull this information.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. So let me start off by giving you the policy number, the correct policy number. Let me know when you're ready.
[CUSTOMER][NEUTRAL] Uh, go right ahead.
[AGENT][NEUTRAL] OK, the policy number is 02462888.
[AGENT][NEUTRAL] Effective date is December. OK, go ahead.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Oh no, go right ahead.
[AGENT][NEUTRAL] OK. Effective date is [PII] and it is active.
[CUSTOMER][NEUTRAL] OK and you said the ID number was 0246288?
[AGENT][NEUTRAL] 8. It's gonna be um after the 2 is [PII]/8, the consecutive 8s.
[CUSTOMER][NEUTRAL] 03 8 OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. And let me go ahead and give you benefits and this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer.
[CUSTOMER][NEUTRAL] OK, alright.
[AGENT][NEUTRAL] I see.
[AGENT][NEUTRAL] OK. So this one has an office treatment rider which is only for office procedures or office treatment. It does not cover the office visit. It will only cover procedures, and this is subject to the outpatient maximum which is 7500 per covered person per calendar year, and this is a combined benefit with inpatient and outpatient service.
[CUSTOMER][NEUTRAL] OK, and has any of that been met?
[AGENT][NEUTRAL] I can check and see.
[AGENT][NEUTRAL] All right. And it looks like as of today, for [PII]025, she has to use $78.22 $78.22 as of today.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Alright, well that is all I was waiting for today then. And can I have your name again please and a reference number?
[AGENT][NEUTRAL] My name is [PII]. That's S as in Sam, O as in Oscar, L as in Lima. Last initial is M as in Mary, and we don't have reference numbers. You can use my name in today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right well thank you so much for your help today.
[AGENT][POSITIVE] You're welcome and thank you for calling APO. Have a good day, Ms. Jackline.
[CUSTOMER][POSITIVE] You too thank you bye bye.
[AGENT][POSITIVE] Thank you, and you're welcome bye bye.