AccountId: 011433970860
ContactId: 06a18832-7668-4f0c-a336-0b947b5b1da3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 207889 ms
Total Talk Time (AGENT): 104840 ms
Total Talk Time (CUSTOMER): 61097 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/06a18832-7668-4f0c-a336-0b947b5b1da3_20250206T18:53_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. I'm calling from Forage dermatology regarding a mutual patient for benefits on his gap insurance secondary.
[AGENT][POSITIVE] OK, I can help you with benefits. Can you please give me your name and your callback number?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, thank you. And what's the patient's name?
[CUSTOMER][NEUTRAL] Patient's name is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And the patient's, uh, policy number, please?
[CUSTOMER][NEUTRAL] The patient's policy number is 023233-84.
[AGENT][NEUTRAL] OK, let me look that up.
[CUSTOMER][NEUTRAL] Hey.
[AGENT][NEUTRAL] OK, I do show that Constanza does have a lapsed policy. The policy is no longer active as of [PII].
[AGENT][NEUTRAL] And I'm looking, but there is another policy that is active. Let me look at it.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Constanza does have an active policy number 235.
[AGENT][NEUTRAL] 3165.
[AGENT][NEUTRAL] And the effective date is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And this is just to verify coverage it's not a guarantee of payment.
[AGENT][NEUTRAL] This is a, as you said, a supplemental insurance policy, a gap insurance that helps with deductible, co-pay, or co-insurance.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] The insured has an inpatient calendar year benefit amount of $2000 and an outpatient calendar year benefit amount also of $2000.
[CUSTOMER][NEUTRAL] OK, thank you. I wanted to know if it covers the primary insurance deductible and copay.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Right, so the primary insurance is billed first and then we're billed secondary, and we pay based on what the primary pays, and the policy does help with deductible copay or co-insurance.
[CUSTOMER][NEUTRAL] OK, so it does cover the copay, correct?
[AGENT][NEUTRAL] Right, deductible, co-pay, or co-insurance?
[CUSTOMER][NEUTRAL] OK, thank you for confirming that. Can I please have a reference number?
[AGENT][NEUTRAL] Yes ma'am, you can use my name it's [PII].
[AGENT][NEUTRAL] And today's date.
[CUSTOMER][POSITIVE] Perfect thank you so much. Have a great day.
[AGENT][POSITIVE] You too thank you. I'll let you have a day off. Thanks for calling APL.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] Thank you bye bye.