AccountId: 011433970860
ContactId: df6ecc8c-2683-4837-accf-233df3623da7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 227960 ms
Total Talk Time (AGENT): 93461 ms
Total Talk Time (CUSTOMER): 74093 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/df6ecc8c-2683-4837-accf-233df3623da7_20250224T20:23_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][POSITIVE] Um, I would like, I'm sorry, I would like to get eligibility and benefits for a patient.
[AGENT][NEUTRAL] OK, I can verify eligibility and benefits for you and your name is?
[CUSTOMER][NEUTRAL] [PII] And your name is [PII]?
[AGENT][NEUTRAL] Uh [PII], last initial [PII]
[AGENT][NEUTRAL] And Ms. [PII], what is that policy number, please?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] 01666016 Mama Lima 8.
[AGENT][NEUTRAL] OK, thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Uh, let's see. I'm showing that policy number you gave it terminated [PII]. However, they do have an active policy, and I can give you that number when you're ready.
[CUSTOMER][NEUTRAL] Uh, what's the new member ID?
[AGENT][NEUTRAL] It's 246-497-8.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Effective [PII] and the policy is active.
[AGENT][NEUTRAL] And what benefits are you needing for the patient?
[CUSTOMER][NEUTRAL] Sorry, effective date is [PII] or [PII]?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Um, I'm calling for specialist office visit.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What's the group number for this plan?
[AGENT][NEUTRAL] Uh, group number is 16143, and under this policy, it does not cover office visits. The insured has a rider that covers procedures in office for sickness or an injury as outpatient, but the visit itself is not covered.
[CUSTOMER][NEUTRAL] Is there uh an outpatient benefit maximum?
[AGENT][NEUTRAL] Uh, yes, um, not a guarantee of payment, just a verification coverage. Uh, the patient has a benefit max up to 2500 per calendar year.
[CUSTOMER][NEUTRAL] Um, it's, what's the accumulation?
[AGENT][NEUTRAL] Uh, the patient has not used any benefits, so it is available.
[CUSTOMER][NEUTRAL] OK, hold on.
[CUSTOMER][NEUTRAL] Just see.
[CUSTOMER][NEUTRAL] Is there um a reference number for this call?
[AGENT][NEUTRAL] Uh, no, ma'am. We don't give uh reference numbers, but you may use my name in today's date.
[CUSTOMER][POSITIVE] OK, that will be all. Thank you so much.
[AGENT][POSITIVE] Alright, you're welcome. Thanks for calling APM, Miss [PII]. Have a great day.
[CUSTOMER][NEUTRAL] You do. Um, are, are you still there?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Hello? Uh, what's the type of plan? Is this, is this an HMO, PPO supplemental?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] This is a secondary, secondary supplemental.
[CUSTOMER][POSITIVE] All right, thank you so much. I will be all.
[AGENT][POSITIVE] All right, you're welcome. Thanks for calling APL. Bye.
[CUSTOMER][POSITIVE] Thank you. Bye.