AccountId: 011433970860
ContactId: 0d0113a7-30ec-4616-a03c-40d620b3032d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 271720 ms
Total Talk Time (AGENT): 127386 ms
Total Talk Time (CUSTOMER): 73853 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/0d0113a7-30ec-4616-a03c-40d620b3032d_20250110T17:41_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I'm calling from Doctor [PII]'s office. How are you?
[AGENT][POSITIVE] I'm doing well how are you doing today?
[CUSTOMER][NEUTRAL] Good, thank you. I just need to see um I have a patient trying to make an appointment and I guess they're, you guys are, they're stating that you guys are like a secondary plan for them and I need to verify if that's correct and what their benefits are, please.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yes, I can help you with eligibility and benefits. Can I please get your name and your callback number?
[CUSTOMER][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then what's the patient's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and what's [PII]'s date of birth?
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] OK, and then what is her policy number?
[CUSTOMER][NEUTRAL] 02517181 M like mom L for Larry and the number 8.
[AGENT][NEUTRAL] OK, let me pull that policy in for us real quick.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're very welcome.
[AGENT][NEUTRAL] All right, I do show that Ms. [PII] does have an active policy with us. Her effective date is [PII].
[AGENT][NEUTRAL] And this is to verify coverage. It's not a guarantee of payment. You are correct. This is a supplemental insurance policy that's billed secondary to the primary. It's a gap insurance that helps with deductible, co-pay, or co-insurance.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] If Miss [PII] goes inpatient, she has a calendar year, I'm sorry, per recurrence.
[AGENT][NEUTRAL] Benefit amount of $2000 if she's in the hospital for 18 hours or more. If she's outpatient, she has outpatient benefits per calendar day of $750.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But what about for like a specialist office visit that you guys just pick up like on her co-payment?
[AGENT][NEUTRAL] Right. It only helps with deductible, co-pay, or co-insurance. Let me see if the specialist is um on the policy. It's gonna be just a second, right. I'm gonna, I'm gonna pull in her policy and actually read it. So it's gonna take the computer a little bit to download it for me and uh let me find that information for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Covered? OK.
[CUSTOMER][NEUTRAL] Do you know the claims mailing address by by heart by any chance?
[AGENT][NEUTRAL] Uh, yes ma'am. I do have it. It's um [PII].
[AGENT][NEUTRAL] And that's [PII].
[AGENT][NEUTRAL] And that is in [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I do see that office visits are covered under the policy.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] Um, OK. That's all. Can I have your name, please?
[AGENT][NEUTRAL] Yes, ma'am. My name is [PII]
[CUSTOMER][NEUTRAL] Initial to your last name?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And can I have a call reference number, [PII]?
[AGENT][NEUTRAL] Yes, ma'am. You can use my name and today's date.
[CUSTOMER][POSITIVE] OK honey, thank you so much I appreciate it have a great day.
[AGENT][NEUTRAL] You