AccountId: 011433970860
ContactId: fa88412f-4aee-44c5-b8b8-ac232ff91209
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 158559 ms
Total Talk Time (AGENT): 89149 ms
Total Talk Time (CUSTOMER): 52031 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/fa88412f-4aee-44c5-b8b8-ac232ff91209_20250114T22:45_UTC.wav
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[AGENT][NEUTRAL] Afternoon, thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi I am calling to verify eligibility for a patient please.
[AGENT][NEUTRAL] Sure, I can assist you with the eligibility. May I have your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And may I have a callback number just in case we get disconnected, Mrs. [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] 02546456
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] It's [PII] and it is [PII].
[AGENT][NEUTRAL] Thank you. And you said you need eligibility. We have an effective date of [PII]. It is showing active at the moment and this is one of our limited hospital in the plan.
[CUSTOMER][NEUTRAL] yeah
[CUSTOMER][NEUTRAL] OK, so we're OBGYN is it covered for today's visit?
[AGENT][NEUTRAL] Um, let me check and see what we cover for specialist.
[AGENT][NEUTRAL] And before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage. It looks like we cover $100 per visit, maximum of 4 visits per person per calendar year. This is a combined benefit for um physicians or specialist office visits.
[CUSTOMER][NEUTRAL] So you cover $100 per visit and it's only covered for 4 visits, but what did you say about the combined? Sorry.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Per year.
[AGENT][NEUTRAL] It's combined with either PCP or specialist, so it's a combined benefit. mhm.
[CUSTOMER][NEUTRAL] Oh, OK, I see, I see.
[CUSTOMER][NEUTRAL] OK and then does it show if she's used um this plan yet or no?
[AGENT][NEUTRAL] I started it all over again on [PII].
[CUSTOMER][POSITIVE] Oh OK, OK, alright, OK, perfect, thank you so much and what was your name again?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm. Is there anything else? My name is [PII]. Is there anything else I may help you with today?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] No, that's it.
[AGENT][NEUTRAL] Yeah, mhm, yeah, mhm, OK.
[CUSTOMER][NEUTRAL] Oh wait, yes, yes, yes, yes, I'm sorry, does she have a co-payment or is it only the coverage plan whatever covers?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, it's just an indemnity amount, which is a flat amount.
[CUSTOMER][POSITIVE] I see. OK, alrighty well thank you very much.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good afternoon. This is [PII].
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank