AccountId: 011433970860
ContactId: ebdbb618-77b3-4364-8bd0-d558e1965967
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 171500 ms
Total Talk Time (AGENT): 89588 ms
Total Talk Time (CUSTOMER): 54860 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/ebdbb618-77b3-4364-8bd0-d558e1965967_20250127T14:32_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, I was just trying to see if this patient has benefits.
[AGENT][POSITIVE] OK, sure, I can assist you with benefits. May I have your name?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Miss [PII], may I have a call back number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number? All right.
[CUSTOMER][NEUTRAL] It is 024351777.
[CUSTOMER][NEUTRAL] M as in Mary, L as in Lima, 8.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you and what type of service is being rendered for benefits?
[CUSTOMER][NEUTRAL] Um, just primary care.
[AGENT][NEUTRAL] Office.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, and before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer and let's see.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] For an office, we only cover the procedures or the office treatments. We do not cover the co-payment for the visit. Um, the procedures or treatment done in the office is subject to the outpatient maximum which is $500 per day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm mm mm just writing this down sorry.
[CUSTOMER][NEUTRAL] And does it have a copay amount that they would pay in the office?
[AGENT][NEUTRAL] Um, no, we're not the major medical. We are the secondary supplemental plan to the major medical.
[AGENT][NEUTRAL] So it has to be based on what the major medical applies towards the copayment for them to pay.
[CUSTOMER][POSITIVE] Got you OK.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Alright, and does it have a um a date of service that they started the policy?
[AGENT][NEUTRAL] Yes, uh, let me give you the effective date. One moment.
[AGENT][NEUTRAL] All right. We have an effective date of [PII] and it is active at the moment.
[CUSTOMER][POSITIVE] Perfect thank you and is there a reference number that I can put here?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will. Do you need the spelling of my name or any other information, right?
[CUSTOMER][NEUTRAL] Uh, yes, that's it.
[AGENT][NEUTRAL] OK, sure. My name is [PII]. That's [PII].
[CUSTOMER][POSITIVE] Perfect, I got you thank you that's all I needed.
[AGENT][POSITIVE] You're welcome and thank you for calling APO. Have a good day, Miss.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you, bye bye.