AccountId: 011433970860
ContactId: d86dc6e9-270b-405c-869c-3c05da02162e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 313609 ms
Total Talk Time (AGENT): 139757 ms
Total Talk Time (CUSTOMER): 131224 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/d86dc6e9-270b-405c-869c-3c05da02162e_20250114T15:25_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello, can you hear me?
[AGENT][NEUTRAL] Yes, this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Hello, my name is [PII]. I'm calling from the office. I need patient benefits and eligibility.
[AGENT][POSITIVE] OK [PII], yeah, I'd love to help you with some eligibility and benefits today and do you mind if I snag a good callback number from you real quick?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yes, the callback number is [PII].
[AGENT][POSITIVE] 68. Perfect. Thank you so much. Give me one second.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And may I also get that policy number today?
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Yes, sure. Policy number is D 45302593.
[AGENT][NEUTRAL] OK, perfect. So that policy number that starts with a D is actually gonna be the policy number for the 90 degree benefits and IMA but not for us here at APL. Um, they might have another policy number. It's like 6 to 8 digits on their card.
[CUSTOMER][NEUTRAL] P
[CUSTOMER][NEUTRAL] Um, how many digits 8.
[AGENT][NEUTRAL] It's 6 to 8 digits, yeah.
[CUSTOMER][NEUTRAL] Uh, I have a number. It's 02514682.
[AGENT][POSITIVE] Perfect, let me pull that up for you, thank you.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Let me see, [PII], could you verify for me please your patient's first and last name and date of birth?
[CUSTOMER][NEUTRAL] First name is [PII]. Last name is [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][POSITIVE] Perfect.
[AGENT][NEUTRAL] And let's see, um, your patient is current and active with us it looks like she has an effective date of.
[CUSTOMER][NEUTRAL] Um.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] The
[AGENT][NEUTRAL] Um, and then as far as benefits go, what benefits were we looking for today?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Specialist office visit.
[AGENT][NEUTRAL] Office visits, OK, um, I do wanna let you know that any benefit information I give you over the phone is just gonna be a verification of coverage and not a guarantee of payment.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, your patient has, um, and then this policy is a limited hospital indemnity policy, so it's a supplemental plan, um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] They
[AGENT][NEUTRAL] She does have an outpatient accident and sickness treatment benefit, so if she's coming in for um accident injury sickness, um, she has up to 4 doctors visits a year with a benefit of up to $50 each visit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Here.
[CUSTOMER][NEUTRAL] Actually my provider's specialty is neurology.
[AGENT][NEUTRAL] It doesn't um distinguish as far as specialties go it just says physician's office.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so the patient has 4 office visits per year.
[AGENT][NEUTRAL] Yes, 4 visits per calendar year with the benefit of $50 per visit.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and how many it has been used yet?
[AGENT][NEUTRAL] Um, yeah, let me take a look at her calendar year benefits and see if we've used any so far.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Be used any, OK.
[AGENT][NEUTRAL] I have, yeah, there's none used so far.
[CUSTOMER][NEUTRAL] I have, yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] As the patient policy, patient has uh any exceeding amount from corporate dollars with patient responsibility and patient has 4 visits per calendar year and uh and he has used 0 visits.
[AGENT][POSITIVE] Correct, yes.
[CUSTOMER][NEUTRAL] And can I uh have the patient insurance plan name?
[AGENT][NEUTRAL] Yeah, the plan name is HI17B.
[CUSTOMER][NEUTRAL] Yeah, the
[CUSTOMER][NEUTRAL] 17, OK.
[CUSTOMER][NEUTRAL] Anything else?
[AGENT][NEUTRAL] No, that's it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I have your name and last initial, please?
[AGENT][NEUTRAL] My last initial, you bet you it's [PII].
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Um, I do I, but I'm not sure if it matters, but yeah, [PII]
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] OK and you call reference number please.
[AGENT][NEUTRAL] Yeah it's actually just my first name, last initial and today's date, sir.
[CUSTOMER][NEUTRAL] Yeah, I.
[CUSTOMER][POSITIVE] OK, thank you so much. Have a good day and
[AGENT][POSITIVE] Hey, it's my pleasure, [PII]. Thank you.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] Bye-bye.