AccountId: 011433970860
ContactId: f58898dd-3d98-40d6-835f-7ab38fc7bae1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 163550 ms
Total Talk Time (AGENT): 84480 ms
Total Talk Time (CUSTOMER): 32810 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/f58898dd-3d98-40d6-835f-7ab38fc7bae1_20250108T20:21_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling to get benefits and eligibility on a patient please.
[AGENT][POSITIVE] OK, yeah, I'd love to help you with that, Ms. [PII]. Do you mind if I also get a good call back number from you?
[CUSTOMER][NEUTRAL] Sure [PII].
[AGENT][NEUTRAL] Perfect and you said you're looking for eligibility today is that correct?
[CUSTOMER][POSITIVE] That is correct.
[AGENT][NEUTRAL] Perfect and what's your member's policy number?
[CUSTOMER][NEUTRAL] Policy number I have on file is 02477116.
[AGENT][POSITIVE] Perfect.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Give me a moment to get all of that pulled up for you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And would you be able to verify for me, pretty please, your patient's first name, last name, and date of birth?
[CUSTOMER][NEUTRAL] Yes, so [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Perfect. I do see Ms. [PII] here. It looks like she is current and active with us, um, and then she has an effective date. I'm so sorry, effective date of [PII].
[CUSTOMER][NEUTRAL] And [PII], I'm just looking for um outpatient benefits please.
[AGENT][POSITIVE] Outpatient benefits, you bet you, no worries. Let me get this pulled up for you and while I'm pulling up.
[AGENT][NEUTRAL] That I do want to let you know that any benefit information I give you over the phone is just an I cannot talk today, a verification of coverage and not a guaranteed payment.
[CUSTOMER][NEUTRAL] Of course.
[AGENT][NEUTRAL] And it looks like for outpatients, um, Ms. [PII] has
[AGENT][NEUTRAL] Um, a $7000 outpatient maximum per calendar year.
[CUSTOMER][POSITIVE] Perfect. And do you know how much he's met towards the $7000 of yet?
[AGENT][NEUTRAL] Yes, let me take a look and see if she has used any for the [PII] calendar year yet.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Yeah, it's my pleasure.
[AGENT][NEUTRAL] And while I'm waiting for that screen to load, um.
[AGENT][NEUTRAL] me just a minute.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright, I'm not showing anything new so far um for the calendar year.
[CUSTOMER][POSITIVE] Perfect, thank you [PII] that will actually be all. Have a wonderful day.
[AGENT][POSITIVE] Hey, thank you so much, Ms. [PII]. You too and take care.
[CUSTOMER][NEUTRAL] Goodbye.
[AGENT][NEUTRAL] Bye.