AccountId: 011433970860
ContactId: e58442b1-39f5-4cf9-aa8a-0590727b9ddc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 338760 ms
Total Talk Time (AGENT): 123991 ms
Total Talk Time (CUSTOMER): 88755 ms
Interruptions: 1
Overall Sentiment: AGENT=1.6, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/e58442b1-39f5-4cf9-aa8a-0590727b9ddc_20250403T20:16_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello. Hi, this is [PII] calling from [PII]. How are you doing today?
[AGENT][POSITIVE] Thank you
[AGENT][POSITIVE] I'm good, thanks for asking. How are you?
[CUSTOMER][POSITIVE] I'm also doing good. Actually, I need eligibility and benefits of this patient. Could you help me for that?
[AGENT][POSITIVE] Sure, I can assist you with that. Can I have your name and a callback number?
[CUSTOMER][NEUTRAL] My name is [PII]. Callback number is [PII].
[AGENT][NEUTRAL] Could you spell your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And what is the policy number of the member that you're calling to verify benefits eligibility for today?
[CUSTOMER][NEUTRAL] 00914813.
[AGENT][NEUTRAL] Verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you, and you're calling to verify benefits eligibility. This policy has been active since [PII] and it's currently active.
[CUSTOMER][NEUTRAL] Patient is the policyholder of this plan?
[AGENT][NEUTRAL] Yes, that is correct. He's the only member of the plan. It's an individual policy.
[CUSTOMER][NEUTRAL] OK. May I know the deductibles and yearly max of this patient, please?
[AGENT][NEUTRAL] This yearly max is $1500 per calendar year with a $50 deductible per insured up to $150 per family, and this is not a guaranteed benefits, just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] Family is 150.
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] Group name and group number?
[AGENT][NEUTRAL] Group number is 14564. That's 14564. Group name is Universal Trucking Anderson Flatbed.
[CUSTOMER][NEUTRAL] Just a second, ma'am.
[CUSTOMER][NEUTRAL] Coincidence services of preventive basic and major.
[AGENT][NEUTRAL] Preventative is covered at 100, basic is covered at 80, and major is covered at 40.
[CUSTOMER][NEUTRAL] Group name and group number Universal tracking 15464, right?
[AGENT][NEUTRAL] Repeat yourself.
[CUSTOMER][NEUTRAL] Universal tracking.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Effective date of this patient?
[AGENT][NEUTRAL] And what did you say the group number was? You didn't repeat the group number. You just repeated the group name.
[CUSTOMER][NEUTRAL] 1514564.
[AGENT][POSITIVE] Yes, that is correct.
[AGENT][NEUTRAL] This policy has been active since [PII], so are you gonna allow me to answer the questions that you're asking first before you ask another question or you're gonna move forward?
[CUSTOMER][NEUTRAL] Is there any use them on?
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] OK, ma'am. Yeah. May I know, is there any history which might affect the frequency?
[AGENT][NEUTRAL] Repeat that question again.
[CUSTOMER][NEUTRAL] Is there any history of this patient which might affect the frequency?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] There is no history on file?
[AGENT][NEUTRAL] There is history on file, however, I would need a code to verify the history that you're inquiring about.
[CUSTOMER][NEUTRAL] I need full history of this patient which might affect the frequency.
[AGENT][NEUTRAL] So what is the first procedure called that you would like for me to check the status, the history of?
[CUSTOMER][NEUTRAL] Ma'am, for all coats.
[AGENT][NEUTRAL] Um, I don't, I'm not sure which cos it is that you're wanting me to check the history for, so could you provide me with a code? That'd be great for, very helpful.
[CUSTOMER][NEUTRAL] OK. 02100330.
[AGENT][NEUTRAL] I could barely hear you and I can only do one code at a time, so if it's possible, could you speak a little louder and clearer and slower so that I can retrieve the information that you're providing me so I could be some assistance to you.
[CUSTOMER][NEUTRAL] 0.
[CUSTOMER][NEUTRAL] OK. 02100330. Sorry, 0210 1st.
[AGENT][NEUTRAL] So I can only look at one code at a time. So what is the first code again?
[CUSTOMER][NEUTRAL] 0210.
[AGENT][NEUTRAL] There's no history on file. What is your next code?
[CUSTOMER][NEUTRAL] 0330
[CUSTOMER][NEUTRAL] It's
[AGENT][NEUTRAL] This was received on.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 79534 is covered.
[CUSTOMER][NEUTRAL] Um, it's.
[AGENT][NEUTRAL] Repeat yourself.
[CUSTOMER][NEUTRAL] 7953.
[AGENT][NEUTRAL] What is the description of that code?
[CUSTOMER][NEUTRAL] Bruga
[CUSTOMER][NEUTRAL] 7953.
[AGENT][NEUTRAL] What is the description of the code?