AccountId: 011433970860
ContactId: eae42d98-6e4c-4eb7-a999-7752712c8675
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 131550 ms
Total Talk Time (AGENT): 52480 ms
Total Talk Time (CUSTOMER): 68075 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/eae42d98-6e4c-4eb7-a999-7752712c8675_20250610T19:44_UTC.wav
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[AGENT][NEUTRAL] For calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Hey [PII], good afternoon. My name is [PII]. I'm calling from a provider's office just needing to verify benefits on a patient.
[AGENT][POSITIVE] I'd be happy to assist with benefits and eligibility today [PII], if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] Sure, absolutely, [PII].
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] Uh, policy number that I show is 02635819.
[AGENT][NEUTRAL] Patient's name and date of birth.
[CUSTOMER][NEUTRAL] Sure, for [PII], date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that information. Please be advised the verification of coverage is not a guarantee of payment. I do show the policy is currently active. Effective date is [PII].
[AGENT][NEUTRAL] And are you calling for inpatient or outpatient benefits?
[CUSTOMER][NEUTRAL] Uh, for outpatient benefits, it's just a primary care office is?
[AGENT][NEUTRAL] OK, I do show.
[AGENT][NEUTRAL] She is coming for the treatment and procedures at the visit, the co-pay associated with the physician's charges would not be covered, and the per day maximum is $500.
[CUSTOMER][NEUTRAL] OK, so the copay that like the the primary insurance would not be covered.
[AGENT][NEUTRAL] Correct. Only any um treatment or procedures at the visit, not the physician's charges.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Tri
[CUSTOMER][NEUTRAL] I got you, so like if the patient had a shot or an injection or something like that.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, treatment or procedures, X-rays maybe does that is that covered?
[AGENT][NEUTRAL] Right, right.
[CUSTOMER][POSITIVE] OK, got you. OK, alright, that makes perfect sense. Alright, well I appreciate your help thank you so much.
[AGENT][NEUTRAL] Was there anything else I could assist with today?
[CUSTOMER][NEUTRAL] Um, let's see, for claims they go to the [PII].
[AGENT][POSITIVE] That's correct.
[CUSTOMER][POSITIVE] City? OK alrighty I will go ahead and get this loaded up and I appreciate your time thank you very much have a good day.
[AGENT][POSITIVE] Thank you for calling APL. You have a good day. Thanks.
[CUSTOMER][NEUTRAL] You too bye bye.