AccountId: 011433970860
ContactId: df283d76-51f9-4d05-a912-38d2d2725995
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 178500 ms
Total Talk Time (AGENT): 97238 ms
Total Talk Time (CUSTOMER): 56927 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=2.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/04/df283d76-51f9-4d05-a912-38d2d2725995_20250404T18:03_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, how are you?
[AGENT][POSITIVE] Good, how are you?
[CUSTOMER][POSITIVE] Good good um I am calling to get benefits and eligibility for a member please.
[AGENT][NEUTRAL] OK, I'm happy to check on benefits and eligibility. What's the patient's policy number?
[CUSTOMER][NEUTRAL] Of course it's 022.
[CUSTOMER][NEUTRAL] 301
[CUSTOMER][NEUTRAL] 28 ML 8.
[AGENT][POSITIVE] Thank you for that. And then if I could just grab your first name and a callback number, please?
[CUSTOMER][NEUTRAL] Of course [PII] and it's [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And then what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Of course, the name is [PII], and then it's [PII].
[AGENT][NEUTRAL] Thank you. So the patient is active. The effective date on the plan is [PII]. We are the member secondary insurance, so this is gonna cover deductible, co-pay, co-insurance that the primary does not.
[CUSTOMER][NEUTRAL] OK, but you guys don't cover office is it correct?
[AGENT][NEUTRAL] Uh, let me check and see. Some of these will cover the office visit fee, some don't. So I'll double check for you here, one second.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] Yeah, because we, yeah, we checked it last year and they didn't cover it, so I don't know if the plan changed.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Right, yeah. Some of them just do, uh, some of them just cover like any treatment or, you know, in the office settings, so.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's what they had yet last year. No office visit was not covered, but the plan paid up to $1500 for any procedure or anything.
[AGENT][NEUTRAL] OK. Yeah, let me just, I'll double check that really quick here.
[AGENT][POSITIVE] Yeah, no worries.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] All right. So it looks like the
[AGENT][NEUTRAL] Outpatient amount is the same. It's still the 1500 for the calendar year, and it looks like it's not gonna cover the office visit fee, just any sort of treatment in the office.
[CUSTOMER][POSITIVE] OK, perfect. And do you know how much they met out of the 1500 if they met anything?
[AGENT][NEUTRAL] Uh, yeah, it looks like thus far they haven't used anything for the year.
[CUSTOMER][POSITIVE] Anything perfect. OK, can I get a reference for the call? I didn't catch your name at the beginning. I'm sorry.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] No, that's totally fine. My name is [PII] and that is the call reference with today's date. My name is spelled [PII] and then my last initial, if you need that is [PII].
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] OK perfect thank you so much you have a good weekend OK?
[AGENT][NEUTRAL] You too bye bye.
[CUSTOMER][NEUTRAL] Bye bye