AccountId: 011433970860
ContactId: 06e54d0b-d2e7-4793-a4ee-6eadbf23d0b7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 190020 ms
Total Talk Time (AGENT): 68770 ms
Total Talk Time (CUSTOMER): 94312 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/13/06e54d0b-d2e7-4793-a4ee-6eadbf23d0b7_20250613T12:17_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, good morning. Hi, my name is [PII]. I'm calling you from Mount Sinai Medical Center on behalf of one of your subscribers. I'm looking to get benefits for their plan.
[AGENT][NEUTRAL] Hi.
[AGENT][POSITIVE] All right. Happy to check on benefits. Can I get their policy number, [PII]?
[CUSTOMER][NEUTRAL] Sure thing, just a moment. It is what is the policy number here?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, is it the outpatient benefit cert number, is that it?
[AGENT][NEUTRAL] Mhm. Yeah.
[CUSTOMER][NEUTRAL] OK, so it's 0212.
[CUSTOMER][NEUTRAL] 0254 ML 8.
[AGENT][NEUTRAL] Thank you. And then for documentation, do you have a good callback number, please?
[CUSTOMER][NEUTRAL] that
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. Patient name and date of birth?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] It is [PII] [PII].
[AGENT][NEUTRAL] Thank you. So, patient does have an active plan under a different number. Would you like the active policy number?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, just a moment.
[CUSTOMER][NEUTRAL] Yeah, what's that number?
[AGENT][NEUTRAL] 02175474
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Effective date on this is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So they have a primary insurance, uh, Blue Cross Blue Shield, and they're here to do an X-ray. They would have an associated cost, um, which is a portion of their deductible, and I wanted to know if American Public Life covers that or covers any of the.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] So we are their secondary, yep, we cover deductible copay, co-insurance. The primary does not. The outpatient benefits on this is $500 max, and that's per calendar day.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, have they met or accumulated anything towards.
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] No, because they get that amount every day.
[CUSTOMER][NEUTRAL] Oh, it's every day.
[AGENT][NEUTRAL] It's a calendar day amount. Uh-huh.
[CUSTOMER][NEUTRAL] 00, OK, right.
[CUSTOMER][NEUTRAL] Um, so yeah, they would have a deductible of 467.
[CUSTOMER][NEUTRAL] Uh, just a moment, 467 and a co-insurance of 20%, so that would be covered with this plan, correct?
[AGENT][NEUTRAL] It'll cover up to $500 per day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, may you provide me with a reference number for this call?
[AGENT][NEUTRAL] Call reference is my name with today's date. My name is [PII], that's [PII] initial to my last name is [PII], and then today's date.
[CUSTOMER][NEUTRAL] Yeah, that's
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, thank you very much I appreciate your help.
[AGENT][POSITIVE] You're welcome. Have a good day, [PII].
[CUSTOMER][NEUTRAL] I don't
[CUSTOMER][NEUTRAL] You too bye.