AccountId: 011433970860
ContactId: f905efc9-c52a-485e-8e7e-3843d9d99573
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 115919 ms
Total Talk Time (AGENT): 68280 ms
Total Talk Time (CUSTOMER): 23277 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/02/f905efc9-c52a-485e-8e7e-3843d9d99573_20250602T16:01_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 trying to get outpatient benefits for a member.
[AGENT][POSITIVE] Yes, ma'am. I can assist you with benefits. Um, first, I'll need your name and a good callback number.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK, thank you, [PII]. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] 02595725 ML 8.
[AGENT][NEUTRAL] Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII]
[AGENT][NEUTRAL] OK. Thank you. And just let me advise you that verification of coverage does not guarantee payment of claims. And do you need to just verify the coverage or do you need the status of a claim?
[CUSTOMER][NEUTRAL] Um, their outpatient benefit amount, please.
[AGENT][NEUTRAL] OK. And yes, ma'am. I'm showing the effective date on this policy was [PII]. The policy is still active.
[AGENT][NEUTRAL] And let's see for outpatient.
[AGENT][NEUTRAL] For outpatient, we cover up to $2500 per calendar year for the copay, the co-insurance, and the deductible after the primary insurance processes the claim and the full 2500 is available. She hasn't used any so far this year.
[CUSTOMER][NEUTRAL] All right, perfect. Can I get a reference number for the call, please?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. My name is [PII]. Um it's spelled [PII] Last initial is [PII] and today's date. Um, is there anything else I can assist you with?
[CUSTOMER][POSITIVE] No, that's it. Thank you very much [PII] have a good day.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL. Mm bye.
[CUSTOMER][NEUTRAL] Bye