AccountId: 011433970860
ContactId: f1bd1a4a-487b-44bf-ba22-da0efb966323
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 181660 ms
Total Talk Time (AGENT): 111838 ms
Total Talk Time (CUSTOMER): 75417 ms
Interruptions: 1
Overall Sentiment: AGENT=2.4, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/03/f1bd1a4a-487b-44bf-ba22-da0efb966323_20250603T19:55_UTC.wav
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[AGENT][NEUTRAL] Contacting APL, my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Hi, my name is [PII] and I'm just trying to um get eligibility and benefits for a patient.
[AGENT][NEUTRAL] I can help with eligibility and benefits. [PII], what's that policy number, please?
[CUSTOMER][NEUTRAL] Alright, it is 02545827.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] I appreciate that while I'm looking this up, if I could just have a callback number please in the event that we're disconnected.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] OK, thank you very, very much. So the policy went into effect. [PII]'s policy went into, excuse me, we're looking at [PII], you said [PII] or [PII], I apologize. My earphone is really messing up.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Is it's [PII] no [PII].
[AGENT][NEUTRAL] You said [PII], right?
[AGENT][POSITIVE] [PII]. Thank you, [PII]. OK, I do appreciate that. Thank you, [PII]. And are you able to hear me cause I'm just having a little trouble with my phone.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Wonderful. They're
[CUSTOMER][POSITIVE] Yes, I'm able to hear you mhm.
[AGENT][POSITIVE] Absolutely fantastic. The policy went into effect on [PII]. It is active. Now, this policy has in and out of hospital benefits, um, outpatient in and out of hospital benefits. It is a secondary or gap insurance. Is there anything in particular on [PII] that we are looking for?
[CUSTOMER][NEUTRAL] Hey, because my phone.
[CUSTOMER][POSITIVE] Good.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um, um, we're a specialist, um, eye clinic, so I'm just making sure, you know, it is secondary to his Blue Cross, so, um.
[CUSTOMER][POSITIVE] Just that he was active and there's no um accumulations.
[AGENT][NEUTRAL] What we will do is we will pick up the deductible, co-payment or co-insurance up to $1000 per calendar year for outpatient services.
[AGENT][NEUTRAL] Uh, that's just a verification of the benefits, not a guarantee of payment. [PII] has used $400 of that so far. Now, what we will, um, pick up on, uh, [PII], is for the outpatient services, we will pick up, uh, the, uh, deductible co-payment or co-insurance for treatment or procedures within the physician's office, but not the office visit copay.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So treatment of procedures within the, yeah, we will um be able to do that uh for um that outpatient services for the for the physician's office, just not the office visit copay, and he does have available benefits for that and it is active.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] And um may I get a reference number for the call please?
[AGENT][NEUTRAL] Absolutely. My name is [PII]. The first letter of my last name is [PII], and we're gonna use that today's date as a reference. Is there anything else at all that I may help with?
[CUSTOMER][POSITIVE] No, that was, that was all I needed dear thank you so much.
[AGENT][POSITIVE] OK, thanks for contacting ATO have a good.