AccountId: 011433970860
ContactId: 0da642cc-c11a-4d9c-bb85-7f5f2c9b1ac7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 240369 ms
Total Talk Time (AGENT): 102929 ms
Total Talk Time (CUSTOMER): 81812 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/0da642cc-c11a-4d9c-bb85-7f5f2c9b1ac7_20250528T21:04_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good afternoon [PII]. My name is [PII]. I'm calling from Bap Stop Patient Services. I'm calling to see if a member's plan is currently active.
[AGENT][NEUTRAL] OK, I could check that eligibility for you. um, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Uh yes, callback number will be [PII].
[AGENT][NEUTRAL] Thank you and then do you have that policy number?
[CUSTOMER][NEUTRAL] Yes, policy number will be 0212.
[CUSTOMER][NEUTRAL] 895, M for Mike, L for Lima, and 8.
[AGENT][NEUTRAL] OK, I think I'm missing a digit there uh before the MLA. I'm sorry, [PII], would you mind repeating that for me?
[CUSTOMER][NEUTRAL] Yes, it was 0212895.
[AGENT][NEUTRAL] OK, yeah, that's not going to be enough digits there. It looks like one is missing. Um, do you maybe have the members social I could search for them that way.
[CUSTOMER][NEUTRAL] Um, yes, let me see here.
[CUSTOMER][NEUTRAL] Yes, the social would be [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] What was the name of the member?
[CUSTOMER][NEUTRAL] Uh, member's name is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And then uh do you have that member's date of birth?
[CUSTOMER][NEUTRAL] Yes, member's date of birth is [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that. So I did find that policy. Um, the policy number was missing a 5, so it's 02512895.
[CUSTOMER][NEUTRAL] 02512895
[AGENT][NEUTRAL] Correct, and so this policy is active, of course, uh, that 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.
[CUSTOMER][POSITIVE] OK, thank you so much.
[CUSTOMER][POSITIVE] OK. Thank you so much. And uh there's no, is there any max on it? Any, uh, it wouldn't be a gap insurance, correct?
[AGENT][NEUTRAL] Uh, secondary medical, um, was this for, uh, outpatient services?
[CUSTOMER][NEUTRAL] Yes, for outpatient.
[AGENT][NEUTRAL] OK, yeah, and of course I will let you know verification of coverage is not a guarantee of payment for claims, uh, so outpatient benefit for this policy is on a per calendar day basis, so it pays up to $1500 per calendar day. There is no yearly maximum.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] And then I'm assuming there's no uh accumulation as of today, correct?
[AGENT][NEUTRAL] Uh, not today, no.
[CUSTOMER][POSITIVE] Thank you so much and then.
[AGENT][NEGATIVE] Not that we've received.
[CUSTOMER][NEUTRAL] OK perfect um alright [PII], can you just spell for me your first name and last name initial?
[AGENT][NEUTRAL] Sure, it's [PII] Was there anything else I could help you with, [PII]?
[CUSTOMER][NEUTRAL] Uh, no, that'll be all. Um, if I could just get a reference number for the call if you guys have that.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Sure, uh, reference number would just be my first name, last initial, and today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, thank you so much for your help, [PII] you're great. I hope you have a great rest of your day.
[AGENT][NEUTRAL] Of course.
[AGENT][POSITIVE] Yeah, thanks for calling APL you too bye bye.
[CUSTOMER][NEUTRAL] Bye.