AccountId: 011433970860
ContactId: f5c7de9d-ac25-4daf-a48a-f786f2e02d3b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 223399 ms
Total Talk Time (AGENT): 128339 ms
Total Talk Time (CUSTOMER): 52996 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/f5c7de9d-ac25-4daf-a48a-f786f2e02d3b_20250213T18:35_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm calling because I wanna get um coverage for a study for a patient.
[AGENT][NEUTRAL] Um, yeah, we could check, uh, we're just needing to check, uh, benefits.
[CUSTOMER][POSITIVE] Yeah, benefits.
[AGENT][NEUTRAL] Sure, OK, what was your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] Thank you. And do you have the policy number?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Give me one second, sorry. It's 60.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] 801.
[AGENT][NEUTRAL] OK, so that's not our policy, a policy number that's actually our payer ID, um, it's very easy to confuse that on the card. Do you have the card by chance?
[CUSTOMER][NEUTRAL] No, I don't.
[AGENT][NEUTRAL] OK, it is kind of confusing, uh, especially for members because it's really big says ID, um, do you maybe have their social I could search for them that way.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] No, can you use the name and date of birth or?
[AGENT][NEUTRAL] I could do the name if you wouldn't mind spelling out the first and last name for me. Yeah.
[CUSTOMER][NEUTRAL] Yeah, uh [PII], first name.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And then last name, [PII]
[AGENT][NEUTRAL] That's [PII]
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, alrighty, one moment.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what state, uh, does this member live in?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] [PII], OK. And then, yes, do you have his date of birth?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Um, it's [PII].
[AGENT][POSITIVE] OK, perfect. I did find his policy, um, let me know when you're ready and I'll give you that correct policy number.
[CUSTOMER][POSITIVE] OK, yes, please. I'm ready.
[AGENT][NEUTRAL] OK, OK, it is 0258.
[AGENT][NEUTRAL] 3715.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, of course, so it 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 we need to look at, uh, was it outpatient benefits?
[CUSTOMER][NEUTRAL] Um, yes, it's for an office study. I don't know if that makes a difference.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, in a, um, a physician's office environment.
[CUSTOMER][NEUTRAL] It's a specialist office.
[AGENT][NEUTRAL] OK, all right, of course I will let you know verification of coverage is not a guarantee of payment for claims, so they do have coverage for office visits and treatment received in office, so the outpatient benefit is uh $7900 max per calendar year. If you'll give me one moment, I'll see if any of that has been used.
[AGENT][NEUTRAL] OK, none has been used so far this year.
[CUSTOMER][POSITIVE] OK, perfect. Thank you.
[AGENT][NEUTRAL] Of course is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Um, can I have your name and a reference?
[AGENT][NEUTRAL] Sure, reference, OK, reference number would just be my first name, last initial, and today's date. Uh, so my name is spelled [PII]
[CUSTOMER][NEUTRAL] Yeah, just an email reference.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Alright, well thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you. You too.
[AGENT][POSITIVE] Thank you bye bye.
[CUSTOMER][NEUTRAL] Bye.