AccountId: 011433970860
ContactId: ddae9aad-9adb-494e-aec9-e688b49f6e78
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 130479 ms
Total Talk Time (AGENT): 79513 ms
Total Talk Time (CUSTOMER): 39565 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/ddae9aad-9adb-494e-aec9-e688b49f6e78_20250303T19:50_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] For contacting. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. I'm calling to verify benefits for a member.
[AGENT][NEUTRAL] You have the benefits with whom am I speaking to?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] [PII], thank you. What is that policy number that we're looking at today?
[CUSTOMER][NEUTRAL] It is 02249238.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, thank you very much. I just need a callback number, please, in the event that we're disconnected.
[CUSTOMER][NEUTRAL] Bye
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] Thank you. The policy went into effect on [PII], and it is active.
[AGENT][NEUTRAL] Um, now, did you say, I'm sorry, did you say that this is for [PII] or?
[AGENT][NEUTRAL] Or
[CUSTOMER][NEUTRAL] For [PII].
[AGENT][POSITIVE] [PII], thank you very much. Um, she is active.
[CUSTOMER][NEUTRAL] No, of course.
[AGENT][NEUTRAL] Uh, she is active on this policy, um, and the benefits, this is a secondary or gap insurance, and what we do is we pick up the deductible co-pay or coinsurance for in and out of hospital settings. There's also a, um an office visit writer, so she has 4 office visits for calendar year. It's, uh, we will pay up to $25 for each office visit.
[AGENT][NEUTRAL] Um, and for outpatient services, we'll pay up to $500 per occasion, or inpatient services up to $5000 per occasion.
[AGENT][NEUTRAL] And this is just a verification of those benefits, not a guarantee of payment. Now, is there anything in particular that I could tell you about the policy?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Um, no, it was just for the outpatient benefit, um, which you just gave me. So it's 500 per occasion.
[AGENT][POSITIVE] That is correct, yes.
[CUSTOMER][NEUTRAL] OK, perfect. And can, I'm sorry, can I have your name again and a call reference number?
[AGENT][NEUTRAL] Yes, my name is [PII], and we're gonna use that today's date as our reference.
[CUSTOMER][POSITIVE] OK, perfect. Thank you for your help.
[AGENT][POSITIVE] Well, thank you for contacting you have a good day.