AccountId: 011433970860
ContactId: ffde8e93-6d14-4991-9c05-89868e355174
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 390309 ms
Total Talk Time (AGENT): 207471 ms
Total Talk Time (CUSTOMER): 123849 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/ffde8e93-6d14-4991-9c05-89868e355174_20250127T16:02_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] with Prisma Health pre-registration. I'm just calling to verify um.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh, eligibility.
[AGENT][NEUTRAL] OK, yeah, let's help you with that, Ms. [PII]. Do you mind if I grab a good callback number from you real quick?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] Thank you. And what is the policy number we want to look at today?
[CUSTOMER][NEUTRAL] Uh, that would be D 4,371,271,900.
[AGENT][NEUTRAL] Alright, and then would you happen to have that card handy? That the number is gonna be the 90 degree benefits policy numbers and ours should be on there, maybe listed as like a certificate number.
[CUSTOMER][NEUTRAL] Uh, I don't have the card. Let me see if there's a copy of it in our, in our system.
[AGENT][POSITIVE] OK, yeah, absolutely.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, and there's not.
[AGENT][NEUTRAL] OK, I can search for them with their first and last name if you'd like.
[CUSTOMER][NEUTRAL] OK, that's [PII]
[AGENT][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] And TO, no, [PII]
[CUSTOMER][POSITIVE] [PII], yes.
[AGENT][POSITIVE] Perfect. And then do you know what [PII]'s address would be by any chance?
[CUSTOMER][NEUTRAL] I do. It is [PII].
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] And do you know what, maybe even what state he'd be out of?
[CUSTOMER][POSITIVE] Oh, I'm sorry.
[AGENT][NEUTRAL] No, you're OK.
[CUSTOMER][NEUTRAL] OK, it's Monday. I'm sorry, it's [PII].
[AGENT][NEUTRAL] All right, I am seeing a [PII] out of [PII]. And would you be able to verify for me his date of birth, please?
[CUSTOMER][NEUTRAL] That would be [PII].
[AGENT][POSITIVE] Holy smoke, that's him. Thank you so much. And let's see, you're wanting benefits, um, just to make sure we're wanting medical, not dental, correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Yes, ma'am, Medical.
[AGENT][NEUTRAL] Perfect. So his policy with us is a limited possible indemnity policy, and I can give you benefits, but I do wanna let you know that any benefit information I provide today is always just a verification of coverage and not a guarantee of payment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it looks like he's current and active and you said you're wanting, are you inpatient benefits or outpatient? I'm sorry I didn't ask.
[CUSTOMER][NEUTRAL] Um, out outpatient benefits and when did he go active?
[AGENT][POSITIVE] Yeah, that's a wonderful question. Let me pull that back up for you.
[AGENT][POSITIVE] I show that he has been effective with us since.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And I do actually just need to pull out his whole policy document real fast to give you those benefits. One second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Did you have a wonderful weekend?
[CUSTOMER][POSITIVE] I did actually, thank you. How about you?
[AGENT][POSITIVE] I had a great weekend. I got to see [PII] and it was amazing.
[CUSTOMER][POSITIVE] Oh, cool.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh, my birthday was Friday and my best friend's kid, thank you, they kidnapped me on Sunday and I had no idea where we were going, and then I get into the car and they tell me we're going to go to the Biltmore house. So I got to go to the Biltmore House in [PII], that was [PII], I don't know where you're at, but [PII]'s castle that he built in [PII].
[AGENT][POSITIVE] Happy birthday.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] That sounds so fun. What a great best friend that you have.
[CUSTOMER][POSITIVE] It was awesome. Oh yeah, oh yeah, I have, I have two of the best friend best friends anybody could ask for. We've been best friends for over 30 years.
[AGENT][NEUTRAL] That is so
[AGENT][POSITIVE] Wonderful. My best friend and I have been best friends since like 7th grade, and so it's been like almost, it's been like two decades, um, so I I I feel that.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Alright, I do have these benefits pulled up under this policy he has probably a couple different benefits that might interest you. Um, he has an outpatient sickness benefit, so if he's coming to see you for something sickness related, um, he's eligible for up to $75.05 times a year.
[AGENT][NEUTRAL] Um, and then if he's getting any wellness or diagnostic testing done, he does have benefits for diagnostic testing, um, once a year for $250 and a diagnosis or a wellness exam or test for $75 once a year.
[CUSTOMER][NEUTRAL] OK. So this specifically is for an MRI.
[AGENT][NEUTRAL] OK, yeah, let's see if that would fall under the diagnostic testing. Let me pull that up.
[AGENT][NEUTRAL] Call not.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] Oh, it does cover an MRI um under that as a diagnostic testing and so let me go back up to.
[AGENT][NEUTRAL] Those benefits, so it would cover up to $250 per test.
[CUSTOMER][POSITIVE] OK, OK, perfect. All right, well, that takes care of everything I needed and what did you say your name was?
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Oh, it's [PII]
[CUSTOMER][NEUTRAL] OK, thank you. And is there a reference number for the call, [PII]?
[AGENT][NEUTRAL] Yeah, it's just my name [PII]. My last initial B like [PII], and today's date.
[CUSTOMER][POSITIVE] All right, [PII]. Thank you so much for your time.
[AGENT][POSITIVE] Hey, it's my pleasure, [PII] you have such a wonderful day and thank you for calling APL.
[CUSTOMER][POSITIVE] You too. Thank you very much. Bye-bye.
[AGENT][POSITIVE] My pleasure bye bye.