AccountId: 011433970860
ContactId: d6fd0e28-5043-4dfe-a33d-e491916d8d0b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 169970 ms
Total Talk Time (AGENT): 84253 ms
Total Talk Time (CUSTOMER): 55704 ms
Interruptions: 0
Overall Sentiment: AGENT=2.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/d6fd0e28-5043-4dfe-a33d-e491916d8d0b_20250206T16:17_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, yes, I'm calling for benefits and eligibility please for one of our patients.
[AGENT][POSITIVE] It would be my pleasure to assist you. I'm sorry to interrupt you. What is your name, please?
[CUSTOMER][NEUTRAL] No, it's OK.
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[AGENT][POSITIVE] Thank you, [PII]. And what is a good callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number?
[CUSTOMER][NEUTRAL] Of course. It's gonna be 02556452.
[AGENT][NEUTRAL] And the patient's name and date of birth, please, ma'am.
[CUSTOMER][NEUTRAL] [PII] and
[CUSTOMER][NEUTRAL] Sorry, [PII], sorry. And the date of birth, give me one moment.
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] I can help you with those benefits and eligibility for [PII]. I'm showing that her policy is active.
[AGENT][NEUTRAL] Effective date is [PII].
[AGENT][NEUTRAL] And this is a secondary policy to the policyholder's primary insurance.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you were needing benefits also?
[CUSTOMER][NEUTRAL] Yes, um, for office visit and outpatient surgery if it covers office visits.
[AGENT][NEUTRAL] OK. And now this policy does not cover the office visit co-pay. It does cover procedures or treatments performed in a doctor's, but not for the uh consultation.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and it covers up to how much?
[AGENT][NEUTRAL] That is under her outpatient benefit of $8700 per calendar year.
[AGENT][NEUTRAL] Now that is a verification of coverage and not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No problem and um how much has been accumulated for this year?
[AGENT][NEUTRAL] As of right now, [PII] has the full benefit remaining for 2025.
[CUSTOMER][POSITIVE] Alrighty, perfect. That's all that I needed and a reference number?
[AGENT][NEUTRAL] Reference number is my name and today's date.
[AGENT][NEUTRAL] And I spell my name [PII].
[CUSTOMER][NEUTRAL] OK
[AGENT][POSITIVE] OK, it was a pleasure to assist you with those benefits. Anything else I can help you with today?
[CUSTOMER][POSITIVE] No thank you so much for your customer service you have a great rest of your Thursday.
[AGENT][POSITIVE] Well thank you [PII]. I hope you do as well. Thank you for calling APL. Take care.
[CUSTOMER][NEUTRAL] OK.