AccountId: 011433970860
ContactId: eababa78-81ad-4f3e-8944-b3378dd39dcc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 147979 ms
Total Talk Time (AGENT): 66795 ms
Total Talk Time (CUSTOMER): 76819 ms
Interruptions: 3
Overall Sentiment: AGENT=0.8, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/eababa78-81ad-4f3e-8944-b3378dd39dcc_20250620T19:50_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I assist you?
[CUSTOMER][POSITIVE] It's not bad.
[CUSTOMER][NEUTRAL] Um, hi, good afternoon, [PII]. My name is [PII]. I would just like to get benefit information for one of our patients.
[AGENT][NEUTRAL] Sure. I can assist you with that. Could you provide me with the spelling of your name?
[CUSTOMER][NEUTRAL] Uh, it's like [PII]
[CUSTOMER][NEUTRAL] And [PII] is my initial. Can I also have the spelling of your name and your initials? Uh, sure. It's [PII].
[AGENT][NEUTRAL] Of course, it's [PII]. The first initial and my last name is [PII], and can I have a callback number for you, [PII]?
[AGENT][NEUTRAL] And what is that policy number of the member that you're calling to verify benefits for?
[CUSTOMER][NEUTRAL] 02221660.
[AGENT][NEUTRAL] Could you verify the patient's name and date of birth? and I'll be able to assist you.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Uh, [PII], [PII].
[AGENT][NEUTRAL] Thank you. This policy has been active since [PII] when it's currently active. Are you calling to verify benefits for inpatient or outpatient?
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Outpatient specifically specialist office visit and what's the maximum for outpatient benefit maximum?
[AGENT][NEUTRAL] So the member has no benefits for office visits, however, the member outpatient benefits for calendar year.
[AGENT][NEUTRAL] It's $3500 and this is not a guaranteed benefits just a disclaimer of the policy's coverage. So the treatment received in the office would be covered under her outpatient benefits, but office visits are not covered.
[CUSTOMER][NEUTRAL] Uh, what's the accumulation as of today for outpatient benefit maximum?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] This member has utilized $842 for benefits for [PII].
[CUSTOMER][NEUTRAL] $842 even.
[AGENT][NEUTRAL] Could you repeat that?
[CUSTOMER][NEUTRAL] $842 even.
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] All right. Uh, can I have a reference number?
[AGENT][NEUTRAL] We don't provide those. You can use my name in today's date as a reference. Is there anything else that I can assist you with today?
[CUSTOMER][POSITIVE] Uh, that's all for today. Thank you so much, [PII].
[AGENT][POSITIVE] You're welcome, [PII]. Thanks for calling APA. You have a great one as well. Goodbye.
[CUSTOMER][POSITIVE] You too. Take care. Bye-bye.