AccountId: 011433970860
ContactId: fe18fd21-5e3d-40fe-8722-dfd7a38716c5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 122809 ms
Total Talk Time (AGENT): 68462 ms
Total Talk Time (CUSTOMER): 40505 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/fe18fd21-5e3d-40fe-8722-dfd7a38716c5_20250219T19:52_UTC.wav
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[AGENT][POSITIVE] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, uh, my name is [PII]. I'm trying to check eligibility and benefits of a patient, please.
[AGENT][NEUTRAL] Sure, [PII], I can assist you with benefits. Um, first, could I get a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure. [PII].
[AGENT][NEUTRAL] Thank you. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] Policy number is 01611684 M as in Mary L as in Louis 8.
[AGENT][NEUTRAL] Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Her name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] 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. Um, is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Outpatient.
[AGENT][NEUTRAL] OK, for outpatient, we can.
[CUSTOMER][NEUTRAL] Office visit.
[AGENT][NEUTRAL] Pay for services provided in office, we cover up to 1, 1500 per calendar year, and that's for the co-insurance and the deductible after the primary insurance processes the claim, but the co-pay for the office visit is not covered.
[CUSTOMER][NEGATIVE] Co-pay for offices is not covered.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, perfect. May I please have a call reference number?
[AGENT][NEUTRAL] Yes, so the reference number, you can use my name and today's date. My name is [PII]. It's spelled [PII] My last initial is [PII] and today's date. Is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] No, that will be all for today. Thank you. I appreciate your help. Have a good day.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL um bye.
[CUSTOMER][NEUTRAL] Bye.