AccountId: 011433970860
ContactId: 05c97ee5-39dc-4853-9f49-fe504d9c1e92
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 172399 ms
Total Talk Time (AGENT): 62566 ms
Total Talk Time (CUSTOMER): 43813 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/11/05c97ee5-39dc-4853-9f49-fe504d9c1e92_20250411T19:06_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, um, my name is [PII]. I am calling to verify a patient's benefits.
[AGENT][NEUTRAL] OK, [PII], I can help you with benefits. Do you have a good callback number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, thank you. Do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] It is 126-56887.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII]
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, this is not a guarantee of payment. It's basic outline of the policy. Is this for outpatient services?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, they have a calendar year benefit of $4750 maximum payout. That's after primary processes the claim.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] So you guys are secondary.
[AGENT][NEUTRAL] We are, um, we'll potentially pick up any deductible, co-pay or co-insurance that primary does not.
[AGENT][NEUTRAL] And it looks like
[CUSTOMER][NEUTRAL] Gotcha. OK.
[AGENT][NEUTRAL] They do have a calendar year deductible under this policy as well that they have to meet, which is $250.
[AGENT][NEUTRAL] So once they meet that, then we'll pay up to 4750.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and so they haven't met anything?
[AGENT][NEUTRAL] Uh, let me see.
[CUSTOMER][NEUTRAL] Has he met anything or?
[AGENT][NEUTRAL] I don't show anything met this year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And do you need authorization?
[AGENT][NEUTRAL] No authorizations required.
[CUSTOMER][NEUTRAL] OK, great. All right, that's all I needed to know, um, and then I guess just the reference number for our call and that's it.
[AGENT][NEUTRAL] Uh, reference number is just my name and today's date.
[CUSTOMER][NEUTRAL] OK, can you spell your name for me? I'm sorry.
[AGENT][NEUTRAL] Um, it's [PII]'s [PII] First initial to last name is [PII].
[CUSTOMER][POSITIVE] Great. Thank you so much.
[AGENT][POSITIVE] Thank you for calling APL. Have a good weekend.
[CUSTOMER][NEUTRAL] You too bye bye.