AccountId: 011433970860
ContactId: f2d6e624-80bb-4a6f-b818-cfacd8b5cf35
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 274880 ms
Total Talk Time (AGENT): 100846 ms
Total Talk Time (CUSTOMER): 74009 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/f2d6e624-80bb-4a6f-b818-cfacd8b5cf35_20250402T13:48_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII]. Um, I'm calling from Davino Dermatology. I'm trying to check on members eligibility and benefits, please.
[AGENT][NEUTRAL] OK, you said your name was [PII]?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK. Do you have a callback number I can get in case we get disconnected I can call you back.
[CUSTOMER][NEUTRAL] That will be [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Um, sure. It's uh 016593997, M as in Mary, L as in Lima, 8.
[AGENT][NEUTRAL] Thank you, [PII]. Hold on one moment, please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] Patient's name is [PII].
[AGENT][NEUTRAL] And the date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you, [PII], and you are needing benefits?
[CUSTOMER][NEUTRAL] Um, yes, benefits for medical provider.
[AGENT][NEUTRAL] OK, I can help you with that. Hold on one moment, OK?
[AGENT][NEUTRAL] OK, the policy that you gave me canceled 1124. She does have a new policy. Let me give you that policy number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It is 02501812.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] The effective date is [PII]. Any benefits given over the phone is not a guarantee of payment.
[AGENT][NEUTRAL] And is this for outpatient inpatient or a doctor's office?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] This is outpatient specialist office visit in office.
[AGENT][NEUTRAL] So it's for an office visit?
[CUSTOMER][NEUTRAL] Um yes.
[AGENT][NEUTRAL] So, and it's a specialist office visit?
[CUSTOMER][NEUTRAL] Yes, it's with the dermatologist.
[AGENT][NEUTRAL] OK, for a specialist office visit, we pay $50 per office visit.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 4 times per calendar year.
[CUSTOMER][NEUTRAL] And also, I want to check um your network status. Um huh.
[AGENT][NEUTRAL] We do not have a network. This policy coordinates with their primary.
[AGENT][NEUTRAL] We only pick up what is applied to their deductible co-pay or co-insurance only.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] No, right, so if Aetna, for example, this is racist primary is Aetna, so.
[CUSTOMER][NEUTRAL] You go based on what Ano is to you, right?
[AGENT][NEUTRAL] Right. Whatever Aetna applies to their deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] OK, got it. And [PII], can you help me out with the reference number for this call?
[AGENT][NEUTRAL] We do not have reference numbers. You can use my name in today's date.
[AGENT][NEUTRAL] Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Oh, yes.
[CUSTOMER][NEUTRAL] Um, just if you can help me out with the spelling of your name.
[AGENT][NEUTRAL] OK, it's [PII]
[CUSTOMER][POSITIVE] OK. Thank you so much for your help.
[AGENT][POSITIVE] Thank you, [PII], for calling APO. You have a good day.
[CUSTOMER][POSITIVE] Thank you. You too. Bye-bye.
[AGENT][POSITIVE] Thank you, bye.
[AGENT][NEUTRAL] I got