AccountId: 011433970860
ContactId: 0f0fe49a-1a96-4a87-98ef-8efe9ee51abc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 258640 ms
Total Talk Time (AGENT): 95471 ms
Total Talk Time (CUSTOMER): 122248 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/0f0fe49a-1a96-4a87-98ef-8efe9ee51abc_20250304T17:25_UTC.wav
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[CUSTOMER][NEUTRAL] I don't know if
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I'm, I'm, I, I could not hear you kind of spaced out. Hi, good morning. My name's [PII]. I'm calling from Banner. Can you hear me?
[AGENT][POSITIVE] Yes, I can hear you very well Miss [PII].
[CUSTOMER][NEUTRAL] Hello? Hi.
[CUSTOMER][NEUTRAL] Um, I am calling. I have a patient checking in for a CT scan, um, and I'm just trying to verify if this insurance that he provided is gonna come in as a secondary payer for him.
[AGENT][NEUTRAL] OK, I can help you, Miss [PII]. Can I please get your call back number just in case our call is disconnected?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] Yes, please because I'm having a hard time hearing you. It's [PII] and what is your name?
[AGENT][NEUTRAL] My name is [PII]
[CUSTOMER][POSITIVE] Thank you, [PII].
[AGENT][NEUTRAL] You're welcome. And uh getting benefits for, what is the patient's name, please?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] His name is [PII], that's [PII]
[CUSTOMER][NEUTRAL] And his date of birth?
[AGENT][NEUTRAL] And what is his date of birth and policy number?
[CUSTOMER][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] And his policy number is 01369582.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, was 01367582?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, I've got [PII] pulled up and he does have an active policy. His effective date of his policy is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this is just to verify his benefits it's not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] You're correct. This is a supplemental insurance policy that helps with deductible, co-pay and co-insurance.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] He has an uh outpatient benefit of $1250.
[CUSTOMER][NEUTRAL] 1250.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] And he hasn't exhausted any of that?
[AGENT][NEUTRAL] Let me check and see if anything has been used this year for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Because he has a co-payment um with his primary.
[CUSTOMER][NEUTRAL] And it's showing um 500.
[CUSTOMER][NEUTRAL] Uh, 1779.
[AGENT][NEUTRAL] Yes, um, he has not used anything for the year of [PII], so he still has his benefit.
[CUSTOMER][NEUTRAL] He has not used it. Perfect. So I can take that from that. And I'm gonna go ahead and enter this information as his secondary. Um, just so he's aware of this, for any outpatient services, after the [PII], um, this, this a balance, he will have 732 remaining for any outpatient hospital services. Is that correct, [PII]?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Just a ballpark
[AGENT][NEGATIVE] Just by yeah, once that calendar year benefit is exhausted, then it won't pay anymore.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK perfect that's just good information for me to let him know now is an authorization gonna be required with this as adding it to a supplement plan as a secondary?
[CUSTOMER][NEUTRAL] What
[AGENT][NEUTRAL] No, ma'am, because it's not the primary insurance, so he doesn't need an authorization.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Wonderful, [PII], are you able to provide me a call reference number?
[AGENT][NEUTRAL] Yes ma'am, you can use my name and today's date.
[CUSTOMER][POSITIVE] Perfect thank you [PII] you have a great day.
[AGENT][POSITIVE] You too, thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Bye-bye.
[AGENT][NEUTRAL] Mm bye bye.