AccountId: 011433970860
ContactId: d9c6a60a-403c-42f0-8073-3c0b1f884869
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 176020 ms
Total Talk Time (AGENT): 86102 ms
Total Talk Time (CUSTOMER): 72497 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/d9c6a60a-403c-42f0-8073-3c0b1f884869_20250407T16:23_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] [PII], hi, my name is [PII] and I'm calling from Prisma Health and I was just wanting to check on a subscriber's policy. Could you help me with that?
[AGENT][NEUTRAL] Mm
[AGENT][POSITIVE] [PII], it would be a pleasure to assist you with that policy information. What is a good callback number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] The policy number is 02537823.
[AGENT][NEUTRAL] In the patient's name and date of birth, please.
[CUSTOMER][NEUTRAL] [PII] and her date of birth is [PII].
[AGENT][NEUTRAL] All right, thank you. And are you needing eligibility for [PII]?
[CUSTOMER][NEUTRAL] Um, yes, first is the policy active?
[AGENT][NEUTRAL] Yes, ma'am. Her policy is active with the effective date of [PII].
[CUSTOMER][NEUTRAL] OK, and does this policy have any benefits for like office to be seen by primary or specialist?
[AGENT][NEUTRAL] Mhm. Yes, ma'am. She does have offices benefits. We pay $75 per visit.
[AGENT][NEUTRAL] And that is available 5 times per calendar year. Now that is a verification coverage, not a guarantee of payment.
[CUSTOMER][NEUTRAL] Right, OK, up to $75 per visit or you do pay $75 per visit?
[AGENT][NEUTRAL] That is what we pay. This is an indemnity policy, and that $75 benefit is what we pay for the visit.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] OK, and she's got 5 visits per year. Do you know or do you know if she has used any of those visits this year yet?
[AGENT][NEUTRAL] Yes ma'am, for [PII] she has used one of her office visit benefits.
[CUSTOMER][NEUTRAL] So she has 4 remaining, correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And they do crossover. It's like together for specialist and primary, I'm assuming, right?
[AGENT][POSITIVE] It's the same benefit. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, OK, great, [PII], do you get call reference numbers?
[AGENT][NEUTRAL] It's my name and today's date, and I spell my name [PII].
[AGENT][NEUTRAL] And if you would please note that all benefits given over the phone is a verification of coverage and not a guarantee of payment. Anything else I can help you with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That's all I needed I appreciate your help today.
[AGENT][POSITIVE] My pleasure and thank you for calling APL. I hope you have a wonderful day.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] You too. Mm bye-bye.
[AGENT][POSITIVE] Thank you. Bye bye.