AccountId: 011433970860
ContactId: f810d56c-7db1-49ac-8e75-e7c963ac1960
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 171160 ms
Total Talk Time (AGENT): 69186 ms
Total Talk Time (CUSTOMER): 54602 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/15/f810d56c-7db1-49ac-8e75-e7c963ac1960_20250115T14:21_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling to verify eligibility and benefits for one of your members.
[AGENT][NEUTRAL] OK, do you have a callback number I get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Uh yes. 02554.
[CUSTOMER][NEUTRAL] 490 M as in Mary, L as in Larry.
[CUSTOMER][NEUTRAL] 8.
[AGENT][NEUTRAL] Thank you [PII], hold on one moment, please.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And what's that patient's name?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] And her date of birth?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][POSITIVE] Thank you. I'm sorry about that. Thank you, [PII]. And you were just needing benefits?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK. Is it for outpatient, inpatient, or doctor's office?
[CUSTOMER][NEUTRAL] Outpatient uh surgery?
[AGENT][NEUTRAL] OK, I can give you those benefits. It's the effective date is [PII]. Any benefits given on the phones, not a guarantee of payment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] This policy coordinates with their primary insurance. Whatever the primary applies to their deductible, co-pay or co-insurance for outpatient, we'll pay up to $7900 per calendar year.
[CUSTOMER][NEUTRAL] OK. And has any of that been used?
[AGENT][NEUTRAL] Hold on just a moment, I'll check for you.
[AGENT][NEUTRAL] No, ma'am. None of it's been used for this year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, so you will cover all out of pockets up to 7900.
[AGENT][NEUTRAL] Right. What they apply to deductible co-pay or co-insurance.
[CUSTOMER][NEUTRAL] OK, no problem. And what was your name?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] And do you have your reference numbers or is it just your name?
[AGENT][NEUTRAL] Just my name in today's date.
[CUSTOMER][NEUTRAL] OK. I'm sorry, may I have your last initial please?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Great. Thank you so much. Have a good day.
[AGENT][POSITIVE] Thank you, [PII] for calling APL. You have a good day as well.
[CUSTOMER][POSITIVE] Thanks. Bye now.
[AGENT][NEUTRAL] Bye bye.