AccountId: 011433970860
ContactId: f005fbf6-94be-4040-a28e-cb3b63c45dca
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 223660 ms
Total Talk Time (AGENT): 113713 ms
Total Talk Time (CUSTOMER): 59669 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/f005fbf6-94be-4040-a28e-cb3b63c45dca_20250116T14:39_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] Mhm
[CUSTOMER][NEUTRAL] Hi, good morning. This is [PII]. I'm calling from Hope Clinic. I'd like to verify eligibility and benefits and a member.
[AGENT][POSITIVE] Sure, I can assist you with eligibility and benefits, and may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Uh yes, I have 02572218.
[AGENT][POSITIVE] OK. Thank you.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] 7
[AGENT][NEUTRAL] OK, may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yes, [PII], and date of birth is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, here she is. Thank you. All right, and what type of service is being render for benefits, Miss?
[CUSTOMER][NEUTRAL] Office visit?
[AGENT][NEUTRAL] All right. OK, 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. We have an effective date of [PII]. It is active at the moment, and this is one of our limited hospital indemnity plan. And with this one, let's see.
[CUSTOMER][NEUTRAL] You said it's a hospital? Oh, what did you say?
[AGENT][NEUTRAL] Hospital indemnity Hospital indemnity plan.
[AGENT][NEUTRAL] OK, and um bear with me. I'm trying to locate um the office visit benefit. Let me see if we do cover.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] Yes.
[AGENT][NEGATIVE] Deficient office here we go.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK here we go.
[AGENT][NEUTRAL] OK, so we cover $50 per day, maximum of 2 days per covered person per calendar year.
[CUSTOMER][NEUTRAL] OK, so $50 per day?
[AGENT][NEUTRAL] Mhm. Yes.
[AGENT][NEUTRAL] And 2 visits per year.
[AGENT][NEUTRAL] And this is a combined benefit with specialist and PCP.
[CUSTOMER][NEUTRAL] And what was the last part?
[AGENT][NEUTRAL] This is a combined benefit with specialist or PCP.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] OK, so they do have it's $50 per day and 2 visits per year for an office visit.
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] Correct, yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][NEUTRAL] No, that will be all. Can I have your name again and um a reference number for this call?
[AGENT][NEUTRAL] Uh sure. My name is [PII]. That's [PII]. Last initial is [PII], and we don't have reference numbers. You can use my name in today's date.
[CUSTOMER][POSITIVE] OK, perfect. OK, thank you so much. So that's all I needed.
[AGENT][NEUTRAL] Mm
[AGENT][POSITIVE] You're welcome and thank you for calling APO. Have a good day. Mm bye.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Nice.