AccountId: 011433970860
ContactId: d7ee2f83-fe0a-48c0-90d1-d6d4f093edd7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 159830 ms
Total Talk Time (AGENT): 65882 ms
Total Talk Time (CUSTOMER): 63258 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/d7ee2f83-fe0a-48c0-90d1-d6d4f093edd7_20250219T15:04_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Good morning. I am actually just calling from a provider's office trying to check the eligibility for a patient for chiropractic services if possible.
[AGENT][NEUTRAL] OK, yes, ma'am. I can verify uh eligibility for you and your name is?
[CUSTOMER][NEUTRAL] Uh, my name is [PII].
[AGENT][NEUTRAL] OK, and Ms. [PII], what is that policy number, please?
[CUSTOMER][NEUTRAL] It is 01851493.
[AGENT][NEUTRAL] OK, and do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. And verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] Um, [PII], I think it's [PII], um, and date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. And you say you're calling for eligibility, correct?
[CUSTOMER][POSITIVE] That is correct.
[AGENT][NEUTRAL] OK, I show her effective date is [PII], and she is active under the policy.
[CUSTOMER][NEUTRAL] OK. Does she have a co-pay for chiropractic services? Um, does she have a deductible or and if so, like, or does she have any benefits for chiropractic at all? If so, how many visits is she allowed for chiro?
[AGENT][NEUTRAL] OK, well, with this policy, we're secondary, we help with primary insurance deductible, co-pay or co-insurance. Uh, she doesn't have benefits for actual visits. Uh, she does have a rider that covers procedures in office, as outpatient.
[AGENT][NEUTRAL] And outpatient pays up to $6000 per calendar year, but there is a $2500 outpatient deductible that has to be met.
[CUSTOMER][NEUTRAL] OK. And I'm sorry, the deductible was the 6 was the 6000?
[AGENT][NEUTRAL] No, that's the benefit max for outpatient, the deductible is the 2500.
[CUSTOMER][POSITIVE] OK, sorry about that.
[AGENT][NEUTRAL] No, you're fine.
[CUSTOMER][NEUTRAL] And has she made either one of those amounts or no?
[AGENT][NEUTRAL] Uh, let me see.
[AGENT][NEUTRAL] Uh, no, she has not, no, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect, thank you. I think that was all I needed.
[AGENT][POSITIVE] OK, and thank you for calling APL Ms. [PII]. You have a great rest of your day.
[CUSTOMER][POSITIVE] You too thank you bye bye.
[AGENT][NEUTRAL] Bye.