AccountId: 011433970860
ContactId: 02944f90-57b1-4f6c-8208-b31ca2a6ea58
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 127800 ms
Total Talk Time (AGENT): 67593 ms
Total Talk Time (CUSTOMER): 38339 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/12/02944f90-57b1-4f6c-8208-b31ca2a6ea58_20250212T16:06_UTC.wav
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[CUSTOMER][NEUTRAL] I would like to work.
[AGENT][NEUTRAL] Calling APL, this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. I'm calling from Aes and Health for eligibility and benefits for patients.
[AGENT][NEUTRAL] OK, yeah, I can check eligibility and benefits for you. Uh, what was your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and then [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yep, um, [PII].
[AGENT][NEUTRAL] Thank you. And do you have the policy number?
[CUSTOMER][NEUTRAL] Uh, it is 02440284. [PII].
[AGENT][NEUTRAL] OK, do you have the date of birth?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you for verifying that. Uh, so this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays, and we really need to look at the outpatient benefit.
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, of course I will let you know verification of coverage is not a guarantee of payment for claims. Uh, so that is outpatient benefits $5000 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, none has been used so far this year.
[CUSTOMER][NEUTRAL] And that's out of pocket?
[AGENT][NEUTRAL] Um, that's the benefit amount that we would pay.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then is there a co-pay or co-insurance?
[AGENT][NEUTRAL] Um, no, so this policy doesn't have any out of pocket again, as long as major medical, um, is willing to pay, then this policy can pay up to $5000 per year.
[CUSTOMER][POSITIVE] Perfect. Thank you so much. I really appreciate your help.
[AGENT][NEUTRAL] Yeah, did you have any other questions for me?
[CUSTOMER][NEUTRAL] No, that's it.
[AGENT][POSITIVE] Alright, well thanks for calling APO. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye bye.