AccountId: 011433970860
ContactId: f9d103f7-a0f4-4a75-b1d8-b9f0fd97d7f9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 154039 ms
Total Talk Time (AGENT): 79171 ms
Total Talk Time (CUSTOMER): 48349 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/11/f9d103f7-a0f4-4a75-b1d8-b9f0fd97d7f9_20250611T17:26_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, um, hi, yes, um, it's um [PII] calling from South Florida ENC Associates and regarding benefits and eligibility please for one of our patients.
[AGENT][POSITIVE] OK, I could check out benefits for you. Um, and, can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And do you have that policy number?
[CUSTOMER][NEUTRAL] Yes, of course. It's gonna be 02252690, M as in Mike, L as in Liam, 8.
[AGENT][NEUTRAL] OK, and then what was the name and date of birth for the member, please?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And her date of birth?
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that. Uh, so this policy is active. Effective date was [PII].
[AGENT][NEUTRAL] 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 reading to look at inpatient or outpatient benefits for this number.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Outpatient and office visit, please.
[AGENT][NEUTRAL] Office visits, OK, and of course I will let you know verification of coverage is not a guarantee of payment for crimes. So under this particular policy office visits are not covered, however, treatment received in office is.
[CUSTOMER][NEUTRAL] OK, and can you provide how much the the plan pays up to?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Of course the outpatient benefit is $4000 per calendar year. If you'll give me one moment, I will see if any of that has been used.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEGATIVE] OK, so none of that benefit has been used so far this year.
[CUSTOMER][NEUTRAL] OK, perfect, and a reference number?
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date. Uh so my name is spelled [PII] Last [PII] Was there anything else I could help you with?
[CUSTOMER][POSITIVE] No, that would be, that would be all. Thank you so much. You have a great rest of your day, OK?
[AGENT][POSITIVE] Of course, thanks for calling APL. You too. Bye-bye.
[CUSTOMER][NEUTRAL] Mm bye.