AccountId: 011433970860
ContactId: 078d0186-dfb1-4986-ac90-ac7b24f508ba
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 209500 ms
Total Talk Time (AGENT): 111136 ms
Total Talk Time (CUSTOMER): 67570 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/078d0186-dfb1-4986-ac90-ac7b24f508ba_20250128T18:06_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yes, my name is [PII]. I'm calling from Gasho Health trying to verify the benefit for two of my patients.
[AGENT][POSITIVE] Yeah, I could take benefits for you. um, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] OK, thank you. Do you have the policy number?
[CUSTOMER][NEUTRAL] Sure, it is 02170589 ML8.
[AGENT][NEUTRAL] OK, thank you and what was the name and date of birth for the member?
[CUSTOMER][NEUTRAL] Patient's name is [PII], [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that [PII]. 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're we need to look at the outpatient benefits?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims. The outpatient benefit is $6600 per calendar year. If you'll give me one moment, I'll see if any of that has been used.
[CUSTOMER][NEUTRAL] OK, so 6,006,000. Can I have your name and a reference number, please?
[AGENT][NEUTRAL] Yeah, reference number would just be my first name, last initial, and today's date. Uh so my name is spelled [PII] last initial is [PII]
[AGENT][NEUTRAL] And did you say that we need to check on another member? Mhm, go ahead.
[CUSTOMER][NEUTRAL] So [PII]
[CUSTOMER][NEUTRAL] Yes, [PII] and they say.
[AGENT][POSITIVE] That's correct, yes.
[CUSTOMER][POSITIVE] OK, perfect, thank you. So let me know when you're ready for the next station.
[AGENT][NEUTRAL] Sure, and I will let you know as well um that the reference number would be the same uh for both of these it would be the same for all that we call about.
[CUSTOMER][NEUTRAL] Got it.
[AGENT][NEUTRAL] OK thank you one moment please.
[AGENT][NEUTRAL] OK, I am ready for that next policy number.
[CUSTOMER][NEUTRAL] It is 01611717 ML 8.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And the name and date of birth for this number?
[CUSTOMER][NEUTRAL] Patient's name is [PII], [PII].
[AGENT][NEUTRAL] Alright, yes, thanks for verifying that. Uh, so this policy is also active. Uh, it's effective date was [PII]. It is also that secondary medical policy. We we checking the outpatient benefits on this one as well?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, their outpatient benefit is $1500 per calendar year.
[AGENT][NEUTRAL] And I can check to see if any of that has been used. Give me just a moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so none of that has been used.
[CUSTOMER][POSITIVE] Got it. Thank you so much. I really appreciate your help.
[AGENT][NEUTRAL] Yeah, was there anything else I could help you with?
[CUSTOMER][POSITIVE] That will be it. It was a pleasure.
[AGENT][POSITIVE] Alright, [PII], thank you for calling APL. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Mhm.