AccountId: 011433970860
ContactId: da89651c-55ba-4034-9f08-641b9d7317ba
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 167630 ms
Total Talk Time (AGENT): 61140 ms
Total Talk Time (CUSTOMER): 72121 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/da89651c-55ba-4034-9f08-641b9d7317ba_20250605T17:28_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, um, I'm calling to verify the patient's insurance eligibility. I don't know if this was the right option, but there was nothing about eligibility and benefits on the menu.
[AGENT][NEUTRAL] Can I have your name and a callback number?
[CUSTOMER][NEUTRAL] Yes, my name is [PII]. Callback number is [PII].
[AGENT][POSITIVE] Thank you [PII]. What is the policy number of the member that you call to verify eligibility and benefits for and I'll be able to assist you.
[CUSTOMER][NEUTRAL] Mhm it's 01960163 M as in Mary, L 8.
[AGENT][NEUTRAL] Thank you, could you verify that patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] This policy has been active since [PII] and it's currently active. What is the place of service that you're calling to verify benefits for? Is the outpatient inpatient, off position?
[CUSTOMER][NEUTRAL] Outpatient, mm, specialist office visits.
[AGENT][NEUTRAL] So the member's policy does not cover office visits, however, it does cover the treatment received in the office which falls under the outpatient benefits of $4000 per calendar year, and this is not a guarantee of benefits, just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, so it covers treatments, not visits.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Could you repeat your question?
[CUSTOMER][NEUTRAL] Uh, it doesn't cover office visits. It will cover, uh, other things like treatments.
[AGENT][NEUTRAL] Yes, treatments received in the office.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][POSITIVE] OK, perfect. I had another question.
[CUSTOMER][NEUTRAL] Um, what type of insurance is this?
[AGENT][NEUTRAL] This is a gap insurance?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the member has not utilized any of the benefits for 2025.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] OK, OK, perfect.
[CUSTOMER][NEUTRAL] And um may I have your name again?
[AGENT][NEUTRAL] Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Just your name, please.
[AGENT][NEUTRAL] Yes, my name is [PII] and today's date as a reference because [PII], we don't provide reference numbers.
[CUSTOMER][NEUTRAL] OK, that's OK.
[AGENT][POSITIVE] Thanks for calling APL and have a great day.
[CUSTOMER][NEUTRAL] And what was the last name of?
[CUSTOMER][POSITIVE] Thank you.