AccountId: 011433970860
ContactId: 03451d98-df1e-4eb5-aa28-8e97abf5c498
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 209720 ms
Total Talk Time (AGENT): 91582 ms
Total Talk Time (CUSTOMER): 59711 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/06/03451d98-df1e-4eb5-aa28-8e97abf5c498_20250506T15:06_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. My name is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, I'm trying to verify medical eligibility on a patient.
[AGENT][NEUTRAL] OK, I can assist with that. And may I have your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you [PII] and your callback number please.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and what is the policy number?
[CUSTOMER][NEUTRAL] 02107801
[AGENT][POSITIVE] Thank you very much. One moment please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you very much, [PII]. You're calling to verify eligibility and [PII] he shows effective as of [PII] and this policy shows active.
[CUSTOMER][NEUTRAL] Uh, what are their medical eligibility for a colonoscopy?
[AGENT][NEUTRAL] OK, the benefits please one moment.
[CUSTOMER][NEUTRAL] Or benefits
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me look at that for you one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Please note verification of benefits provided does not guarantee payment. We will pay up to $500 for the calendar year for covered services. If you like, I can check to see if anything has been accumulated towards that. One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Currently he has not accumulated anything towards the $500 max for the year.
[CUSTOMER][NEUTRAL] OK, and you said the plan pays up to $500 per year?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Do they have a copay or anything?
[AGENT][NEGATIVE] No, he does not.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] OK, I think.
[AGENT][NEUTRAL] Do you need any billing information as far as our fax number, payer ID, mailing address?
[CUSTOMER][NEUTRAL] Uh, let me verify that I have to have that.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Insurance
[CUSTOMER][NEUTRAL] It's a [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] But this would be um a covered benefit, a colonoscopy will go towards the 500.
[AGENT][NEUTRAL] Um, it has
[AGENT][NEUTRAL] It has to be due to a sickness or an injury and it all depends on if the major medical applies any charges towards the deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] Can you repeat that one more time?
[AGENT][NEUTRAL] OK, of course, we are the secondary and if the major medical applies charges to the deductible copay or co-insurance, we will, it has to be due to a sickness or an injury.
[CUSTOMER][NEUTRAL] OK, alrighty, I think that's all I needed um I don't think I need anything else, yep, that was it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, well thank you so much for calling APL. You have a great day and we did not use call reference numbers, but you can use my name [PII] last initials [PII] and today's date.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL and take care.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye.