AccountId: 011433970860
ContactId: fa8c0392-2bd7-485f-9bf7-57edc04625ab
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 170070 ms
Total Talk Time (AGENT): 73341 ms
Total Talk Time (CUSTOMER): 55164 ms
Interruptions: 1
Overall Sentiment: AGENT=0, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/fa8c0392-2bd7-485f-9bf7-57edc04625ab_20250415T18:59_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh hello, my name is [PII]. I'm checking eligibility benefits.
[AGENT][NEUTRAL] I'm sure, [PII], I can assist you with benefits. Um, first, I'll need a good callback number just in case we're disconnected.
[CUSTOMER][NEUTRAL] Yeah, callback number is [PII].
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] Policy number is 02331303.
[CUSTOMER][NEUTRAL] M as in Mike, L Lima, number 7.
[AGENT][NEUTRAL] Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Patient's name is uh [PII].
[CUSTOMER][NEUTRAL] And the date of birth is.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] 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]. The policy is still active. And is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Uh, this is for an outpatient, but I have a specific question, uh.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yeah, so patient has actually, uh, Blue Cross has Prime. Yeah, patient has primary insurance, so does this plan covers family co-pay?
[AGENT][NEUTRAL] What's your question?
[AGENT][NEUTRAL] Um, for what type of service? Um, it covers the primary co-pay for outpatient, um, well, not for office visits. We don't cover the co-pay.
[CUSTOMER][NEUTRAL] Uh, offices
[CUSTOMER][NEUTRAL] Yeah, outpatient.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] You don't know the copay.
[AGENT][NEUTRAL] Right, we don't cover the copay for office visits.
[CUSTOMER][NEUTRAL] So offices services are not covered?
[AGENT][NEUTRAL] We don't cover the co-pay for office visits, but we do cover the co-insurance and the deductible for office visits. We covered that up to 3000 per calendar year.
[CUSTOMER][NEUTRAL] For
[CUSTOMER][NEUTRAL] OK, deductible, you, uh, deductible is covered 3000 per year, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK. Thank you very much. And uh
[CUSTOMER][NEUTRAL] What's your name?
[AGENT][NEUTRAL] My name is [PII]. It's spelled [PII] My last initial is [PII], and my name in today's date is your reference number. Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Uh, no thank you, [PII], thanks for this.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL. Mm bye.