AccountId: 011433970860
ContactId: f0bc04d2-e5c4-4777-bde7-b171fd441172
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 169339 ms
Total Talk Time (AGENT): 78630 ms
Total Talk Time (CUSTOMER): 57420 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/03/f0bc04d2-e5c4-4777-bde7-b171fd441172_20250603T16:35_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Hi yes, I thank you. Good afternoon. I'm calling to check eligibility and benefits for a patient.
[AGENT][POSITIVE] I think those benefits for you. uh, what was your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And let's see.
[AGENT][NEUTRAL] Alright, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] I do. I have 02155489 ML 8.
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, I apologize for the wait. Uh, what was the name and date of birth for the member, please?
[CUSTOMER][NEUTRAL] OK OK.
[CUSTOMER][NEUTRAL] The patient is [PII], [PII].
[AGENT][NEUTRAL] Perfect, thank you so much for verifying that. Uh, so this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays, and we're needing to look at uh inpatient or outpatient benefits for this member.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Outpatient benefits please.
[AGENT][NEUTRAL] OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims, so their outpatient benefit pays on a per calendar day basis, so it pays up to $500 per calendar day. There is no yearly maximum, simply the daily maximum.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] The day that the patient used the, the service. OK. So per calendar day maximum is 500 for outpatient. Got it.
[AGENT][POSITIVE] Correct.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] All right, sounds good. OK, at least something. OK, and what is your name again?
[AGENT][NEUTRAL] Of course. It's [PII] And was there anything else I could help you with?
[CUSTOMER][NEUTRAL] No, [PII], just if you don't mind the initial two last name and a reference number for the call.
[AGENT][NEUTRAL] Oh sure, reference number would just be my first name, last initial, and today's date, um, so my last initial is A.
[CUSTOMER][POSITIVE] OK, OK, got it. Perfect. All right. Thank you so much and you have a good day, OK?
[AGENT][POSITIVE] Of course. You too. Thank you. Bye-bye.
[CUSTOMER][POSITIVE] Thank you bye bye thank you.