AccountId: 011433970860
ContactId: 0099777a-3a8e-409c-84a1-92ca314ecde3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 167389 ms
Total Talk Time (AGENT): 87661 ms
Total Talk Time (CUSTOMER): 50163 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/0099777a-3a8e-409c-84a1-92ca314ecde3_20250421T18:44_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, yes, this is [PII] and I need to get verification of benefits for a patient, please.
[AGENT][POSITIVE] Sure, I could check benefits for you. uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then do you have that policy number?
[CUSTOMER][NEUTRAL] It is 02212492.
[CUSTOMER][NEUTRAL] ML 8.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] [PII] and it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that, [PII]. Uh, so this policy terminated, uh, [PII]. If you'll give me one moment though, I'll see if they have an active policy, could just be a different policy number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, they do, um, have one that is currently active. Uh, whenever you're ready I can give you that correct uh updated policy number.
[CUSTOMER][NEUTRAL] OK, hold on one second, let me get something to write on.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So that policy number is 02.
[AGENT][NEUTRAL] 42
[AGENT][NEUTRAL] 4692.
[CUSTOMER][NEUTRAL] 02424692
[AGENT][NEUTRAL] Correct. And so this one just picked up where the other left off, um, the effective date was [PII], and of course this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays.
[AGENT][NEUTRAL] We we needing to look at uh inpatient or outpatient benefits for this number?
[CUSTOMER][NEUTRAL] Outpatient.
[AGENT][NEUTRAL] OK, and I will let you know verification of coverage is not a guarantee of payment for claims. The outpatient benefit is $5500 max per calendar year. If you'll give me one moment, I'll see if any of that has been used.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, [PII] has used $100 of that benefit so far this year.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, was there anything else I can help you with?
[CUSTOMER][POSITIVE] All right. I sure, not at this time. Thanks for all your help.
[AGENT][POSITIVE] Of course, yeah, thanks for calling APL hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too, bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.