AccountId: 011433970860
ContactId: 0c761809-c89a-469d-9676-b6268bda18c6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 145410 ms
Total Talk Time (AGENT): 59390 ms
Total Talk Time (CUSTOMER): 47033 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/15/0c761809-c89a-469d-9676-b6268bda18c6_20250515T17:03_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, I have a patient I need to get eligibility and benefits for, and I need to see if we're in network with their plan.
[AGENT][POSITIVE] OK, I can help you with the eligibility and benefits. Do you have a, can I get your name and a good callback number?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] And then the callback number is [PII].
[AGENT][NEUTRAL] And you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Yes, it's 02566526.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII]
[AGENT][NEUTRAL] And it shows uh the policy is effective [PII]. It's currently active.
[AGENT][NEUTRAL] Um, there's no network on this plan. It's a secondary policy.
[AGENT][NEUTRAL] And then, do you need outpatient benefits like for hospital or what type of benefits?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, it would be a screening colonoscopy at an outpatient ambulatory surgery center.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, not a guarantee of payment, basic outline of the policy. Let me get that pulled up.
[AGENT][NEUTRAL] Um, outpatient hospital services pay a maximum of $3000 per covered person per calendar year.
[CUSTOMER][NEUTRAL] OK, was that for ambulatory?
[AGENT][NEUTRAL] Uh, yes. And so this will pay after the primary has processed the claim. If there's any coinsurance, deductible leftover, this would pick up up to 3000.
[CUSTOMER][NEUTRAL] OK, so this is not the primary.
[AGENT][NEUTRAL] This is not the primary, no.
[CUSTOMER][NEUTRAL] OK, it's just listed in her that chart, so I guess I'll have to clarify, but um.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] I can see what we have. Let's see. We've got Blue Cross Blue Shield of Oklahoma.
[CUSTOMER][NEUTRAL] OK, yeah, I have that too I guess they just entered it in as a secondary instead of primary um, could I just get a call reference number?
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Uh, yes, it's my name, [PII], first initial to last name, [PII], and today's date.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Thank you for calling APL. Have a great day.