AccountId: 011433970860
ContactId: 0d354ca2-844c-4ea5-a028-fcd3aa8b8c82
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 201550 ms
Total Talk Time (AGENT): 68030 ms
Total Talk Time (CUSTOMER): 100220 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=3.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/06/0d354ca2-844c-4ea5-a028-fcd3aa8b8c82_20250606T17:19_UTC.wav
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[CUSTOMER][POSITIVE] Awesome.
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][POSITIVE] Hey [PII], how are you? My name is [PII]. I'm calling to verify the coverage for a member. If you could help me, I'd greatly appreciate that.
[AGENT][NEUTRAL] I can help you. Did you say it was [PII]?
[CUSTOMER][POSITIVE] You got it perfect, yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And do you have a phone number I can get in case we get?
[CUSTOMER][NEUTRAL] And you are [PII], right?
[AGENT][NEUTRAL] Yes, uh-huh.
[CUSTOMER][NEUTRAL] All right. Uh, phone number would be [PII].
[AGENT][NEUTRAL] Do you have a phone number?
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And do you have their policy number?
[CUSTOMER][NEUTRAL] Uh yes, I do. Uh 02419432 M as in Mike, L as in Lima, number 7.
[AGENT][NEUTRAL] And the patient's name?
[CUSTOMER][NEUTRAL] I have a [PII] born [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And you were just needing benefits?
[CUSTOMER][NEUTRAL] Of course.
[CUSTOMER][POSITIVE] Yeah, effective date and benefits would be greatly appreciated. See what kind of coverage they have for outpatient hospital facility.
[AGENT][NEUTRAL] OK, I can give those to you. The effective date is [PII].
[AGENT][NEUTRAL] Any benefits given over the phone is not a guarantee of payment. This policy does coordinate with the primary insurance, whatever the primary applies to their deductible, co-pay or co-insurance only will pay up to $1000 per calendar year for outpatient.
[CUSTOMER][NEUTRAL] OK, perfect. Co-insurance. So got deductible co-pay, co-insurance up to $1000 for the year, uh, calendar year, correct?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Alright, can you be so kind to let me know what portion of that $1000 has been presently used at this time?
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][POSITIVE] Of course, again, thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEGATIVE] They have not met any of the outpatient benefit.
[CUSTOMER][NEUTRAL] OK, so nothing used yet? OK. OK, perfect. Sounds good. Sounds good, [PII]. And then do I spell your name [PII]? Would that be OK? Or is that incorrect?
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] Yes, that is, that's correct. Mhm.
[CUSTOMER][NEUTRAL] Alright, alright, and do you use, uh, do you use initials to last names for references as well?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, and then what would be a good call reference number I can use or mhm.
[AGENT][NEUTRAL] We do not have call reference numbers. You can use my name in today's date.
[CUSTOMER][POSITIVE] And that'll be enough? OK, perfect. I appreciate your time. That's awesome. And you did say the effective date was [PII] and it's still active, correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Perfect. You've been very kind, [PII]. I wish you a wonderful day and a terrific weekend, OK?
[AGENT][POSITIVE] Thank you, [PII], for calling APL. You as well.
[CUSTOMER][POSITIVE] OK, thanks again. Bye-bye now.
[AGENT][POSITIVE] Thank you, bye bye.
[CUSTOMER][POSITIVE] Thank you.