AccountId: 011433970860
ContactId: 0fb1133b-7d3d-441b-8e00-1e9c3326e40d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 141119 ms
Total Talk Time (AGENT): 65589 ms
Total Talk Time (CUSTOMER): 51997 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/0fb1133b-7d3d-441b-8e00-1e9c3326e40d_20250620T15:51_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, good morning, sir. I was trying to see if you can help me with eligibility and benefits.
[AGENT][POSITIVE] All right. Happy to check on benefits and eligibility. Do we have a policy number for the patient?
[CUSTOMER][NEUTRAL] I do, yes, it is um 01868753.
[AGENT][NEUTRAL] OK. And then for documentation, can I grab your name and a callback number?
[CUSTOMER][NEUTRAL] It's [PII] callback number is [PII].
[AGENT][NEUTRAL] Thank you. Patient name and date of birth?
[CUSTOMER][NEUTRAL] Uh, it is [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Thank you. So, patient is active. Effective date is [PII]. We are the member's secondary insurance, so this will cover deductible, co-pay, co-insurance that the primary does not.
[CUSTOMER][NEUTRAL] OK, it'll cover there's no like limit there's no uh.
[AGENT][NEUTRAL] Uh, there is a limit for outpatient or inpatient. Do you know if they're being seen on an outpatient basis or would you like both?
[CUSTOMER][NEUTRAL] It's in an outpatient, yeah, emergency.
[AGENT][NEUTRAL] OK, so their outpatient benefit max for the calendar year is 2550.
[CUSTOMER][NEUTRAL] And have they used any of that?
[AGENT][NEUTRAL] Let's see, nothing's been used for the year.
[CUSTOMER][NEGATIVE] Nothing right 0.
[AGENT][NEUTRAL] Mhm. Mhm.
[CUSTOMER][NEUTRAL] And this is a PPO plan or?
[AGENT][NEUTRAL] It's a gap plan, so it's their secondary to whoever their primary is.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK and your name you said was [PII], right?
[AGENT][NEUTRAL] [PII] Uh-huh.
[CUSTOMER][NEUTRAL] There
[CUSTOMER][NEUTRAL] Do you have a reference number or is it just your name?
[AGENT][NEUTRAL] Just my name with today's date.
[CUSTOMER][NEUTRAL] OK, and no authorization, right?
[AGENT][POSITIVE] Correct, yeah, not needed.
[CUSTOMER][NEUTRAL] And the claims address I have is uh [PII].
[AGENT][POSITIVE] Mhm, that is correct.
[CUSTOMER][POSITIVE] OK perfect thank you [PII].
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][NEUTRAL] Likewise.
[AGENT][NEUTRAL] Bye bye.