AccountId: 011433970860
ContactId: d2f92ba8-579b-44c3-8a8b-970964b02176
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 395579 ms
Total Talk Time (AGENT): 124969 ms
Total Talk Time (CUSTOMER): 142670 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/27/d2f92ba8-579b-44c3-8a8b-970964b02176_20250227T16:09_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello, [PII]. This is [PII]. How are you?
[AGENT][POSITIVE] I'm great, thanks for asking. How are you?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Very good. And your name is [PII]. It's [PII]?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Could you provide me with the spelling of your name?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah. It's [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII] Yeah.
[AGENT][POSITIVE] [PII] Thank you, [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII], how can I assist you today?
[CUSTOMER][NEUTRAL] Uh, I have a
[CUSTOMER][NEUTRAL] Um, member on my end, I just want to know the eligibility of this number because I was unable to check the eligibility through portal.
[CUSTOMER][NEUTRAL] Can you please help me with that?
[AGENT][NEUTRAL] Could you provide me with the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It's uh 00750467.
[AGENT][POSITIVE] Thank you [PII]. What is a good call back number for you just in case the call is disconnected?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And could you verify that this patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, patient name, it's uh [PII], and date of birth is [PII].
[AGENT][NEUTRAL] And you're calling to verify benefits and eligibility for medical or dental?
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] It's medical.
[AGENT][NEUTRAL] What is the place of service that you're inquiring benefits for?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello. Yes.
[AGENT][NEUTRAL] What is the place of service that you're calling to verify benefits for [PII]?
[CUSTOMER][NEUTRAL] Uh, one moment.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] The place service is 11.
[AGENT][NEUTRAL] Office visit
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] OK, give me one moment.
[AGENT][NEUTRAL] Um.
[AGENT][NEUTRAL] I place you on a brief hold while I transfer you to the direct.
[AGENT][NEUTRAL] Department that assists with this in this um policy?
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you. I'll be right back, [PII].
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Sing.
[CUSTOMER][NEUTRAL] For calling APL, this is [PII]. How can I help you?
[AGENT][NEUTRAL] Hey [PII], how you doing?
[CUSTOMER][NEUTRAL] Fine, how are you?
[AGENT][NEUTRAL] I'm great thanks for asking. [PII]. I have a provider on the phone. He's calling to verify office visit benefits for HR policy. Now I'm looking on and I can read the policy however, I'm not, I'm not showing where like the office visits are covered.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, I can
[AGENT][NEUTRAL] Can I give you a policy number to look at it.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 750467.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh, is this the, is office visit benefits the one on the outpatient sickness benefit rider?
[CUSTOMER][NEUTRAL] Yes, it would be.
[AGENT][NEUTRAL] But what is the benefit amount though?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] See this one, it has the one there so it's most likely $50. Let me look at the actual policy, yeah, when it, with that dollar, um, is usually the, the lower benefit.
[AGENT][NEUTRAL] 501.
[CUSTOMER][NEUTRAL] Uh, let me look on the schedule page here.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh wait, hold on, which policy is this CH uh 45.
[AGENT][NEUTRAL] Excuse me.
[CUSTOMER][NEUTRAL] See if they made some changes to this.
[CUSTOMER][NEUTRAL] Was it
[CUSTOMER][NEUTRAL] Looks like.
[CUSTOMER][NEUTRAL] Hm, what is the whole policy certificate?
[CUSTOMER][NEUTRAL] OK, let's see what this one has here.
[CUSTOMER][NEUTRAL] OK, so it looks like no, theirs is not $50 it's $25. I see the most updated schedule page. So yeah, that one is $25. They get 5 visits per calendar year, yeah, yep.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Her calendar year. OK. All right, I'll let him know. Thank you, [PII].
[CUSTOMER][POSITIVE] Mhm you're welcome.
[AGENT][POSITIVE] Have a good one.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][NEUTRAL] Hello [PII], thank you for holding. So it looks like this policy has $25 per office visit with 5 visits per calendar year, and this is not a guaranteed benefits, just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] OK. Can you please help me with the uh coverage date?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Give me one moment.
[AGENT][POSITIVE] This policy became effective.
[AGENT][NEUTRAL] [PII] and it's currently active. Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] [PII]. [PII].
[CUSTOMER][NEUTRAL] Could you please repeat one?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Thank you for this information. And what is the reference number?
[AGENT][NEUTRAL] We don't provide reference numbers [PII], however, you can use my name in today's date as a reference.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] Nothing. This is the only question I have.
[AGENT][POSITIVE] Thanks for calling APL and have a great day. Goodbye.
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] I.