AccountId: 011433970860
ContactId: f2032373-07e7-4e44-933f-b3049b2d53f5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 193460 ms
Total Talk Time (AGENT): 66989 ms
Total Talk Time (CUSTOMER): 77912 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/11/f2032373-07e7-4e44-933f-b3049b2d53f5_20250311T14:13_UTC.wav
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[AGENT][NEUTRAL] As you
[CUSTOMER][NEUTRAL] Hello?
[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, good morning. This is [PII] from Doctor [PII]'s office. I need to verify benefits for one of our patients.
[AGENT][NEUTRAL] Could you repeat yourself?
[CUSTOMER][NEUTRAL] Hello? Oh.
[CUSTOMER][NEUTRAL] Um, yes, it's just to verify a member's benefits.
[AGENT][POSITIVE] Sure, I can assist you with that. Can I have your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] And a callback number for your engine and the policy number and I'll be able to assist you.
[CUSTOMER][NEUTRAL] Yes, the callback number is [PII].
[CUSTOMER][NEUTRAL] And the member's ID it's 024.
[CUSTOMER][NEUTRAL] 792-46.
[CUSTOMER][NEUTRAL] ML 7.
[AGENT][NEUTRAL] You said 2479246?
[CUSTOMER][NEUTRAL] Uh huh. Then she told me M as in Mary, L as in Larry, 7.
[AGENT][NEUTRAL] Can you verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, the last name is [PII], first name [PII], and it's uh [PII].
[CUSTOMER][NEUTRAL] The.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you're calling to verify benefits and eligibility?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] For inpatient, outpatient office visits?
[CUSTOMER][NEUTRAL] Office visits uh huh.
[AGENT][NEUTRAL] This member's policy has been active since [PII], [PII] and is currently active.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] She has a maximum benefit amount?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK mhm.
[AGENT][NEGATIVE] Of $750 per calendar day for the treatment received in the office. However, the office visit itself is not covered. This is not a guaranteed benefits, just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] OK, so the office visit is not cover at all like no co-payments or anything, you don't cover anything.
[AGENT][NEUTRAL] Not the office visits, no, just the treatment received in the office is covered.
[CUSTOMER][NEGATIVE] No OK.
[CUSTOMER][NEUTRAL] When you say treatment received like let's see if she gets any type of injection first, OK.
[AGENT][NEUTRAL] Like the procedures.
[AGENT][NEUTRAL] Mhm. Yes.
[CUSTOMER][NEUTRAL] And it's up to 750.
[AGENT][POSITIVE] Per calendar day, yes, that is correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, no, can I just get the reference number for the call?
[AGENT][NEUTRAL] We don't provide those, however, you can use my name in today's date as a reference.
[CUSTOMER][NEUTRAL] OK, can you just repeat me your name? I'm sorry.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you so much for your help.
[AGENT][POSITIVE] You're welcome, [PII], thanks for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] You too.