AccountId: 011433970860
ContactId: f9edec49-05d2-44a8-b991-8cde326634eb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 150559 ms
Total Talk Time (AGENT): 73519 ms
Total Talk Time (CUSTOMER): 39610 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/2025/03/20/f9edec49-05d2-44a8-b991-8cde326634eb_20250320T15:07_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Yes ma'am, I need to get eligibility and benefits on a patient.
[AGENT][NEUTRAL] Um, yes, I can assist you with benefits. Um, first, could I get your name and a good callback number?
[CUSTOMER][NEUTRAL] It's [PII] and it's [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] Um, the policy number is.
[CUSTOMER][NEUTRAL] 02465458
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Her date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you and just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII] and the policy is still active. Um, is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] It's outpatient. We file places service 11 for office setting.
[AGENT][NEUTRAL] OK. OK. Well, for services provided in office, for office treatments, we cover up to 2000 per calendar year and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim. But any charges, let's see, for a co-pay for an office visit is not covered.
[CUSTOMER][NEUTRAL] So you cover up to 2000 per year after primary.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] And has that been met yet.
[AGENT][NEUTRAL] Um, no, she actually hasn't used any this year. It's all available.
[CUSTOMER][NEUTRAL] OK, and what was your name?
[AGENT][NEUTRAL] Um, it's [PII]. It's spelled [PII] and my last initial is [PII]. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] Do you have a reference number?
[AGENT][NEUTRAL] You can use my name and today's date for the reference number.
[CUSTOMER][POSITIVE] OK, all right, thank you for your help.
[AGENT][POSITIVE] OK, thank you, [PII] for calling APL. You have a great day. Mm bye.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Mm.