AccountId: 011433970860
ContactId: 140c9b97-6023-4573-9b6f-32f6f5bbf7b8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 230679 ms
Total Talk Time (AGENT): 113609 ms
Total Talk Time (CUSTOMER): 69360 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/140c9b97-6023-4573-9b6f-32f6f5bbf7b8_20250321T15:21_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm calling from Palmetto Bay Diagnostics in regards to a mutual patient of ours.
[CUSTOMER][NEUTRAL] To check their benefits with this plan, please?
[AGENT][POSITIVE] OK, sure, I can assist you with benefits, and I didn't quite catch your name. Can you repeat your name?
[CUSTOMER][NEUTRAL] [PII] from Palmetto Bay Diagnostics.
[AGENT][NEUTRAL] Really.
[AGENT][POSITIVE] OK, thank you. And may I have a call back number just in case we get disconnected Miss [PII].
[CUSTOMER][NEUTRAL] Our callback number is [PII].
[AGENT][NEUTRAL] Thank you and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] OK, I have the payer ID. It's 60801.
[AGENT][NEUTRAL] It's gonna be in the bottom where it says outpatient search.
[CUSTOMER][NEUTRAL] Or [PII]?
[CUSTOMER][NEUTRAL] OK, 0167441138.
[AGENT][NEUTRAL] OK, may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. All right. Um, it looks like we have a different policy for this member, Miss [PII]. Let me know when you're ready for the new policy.
[CUSTOMER][NEUTRAL] OK, can I please get it now?
[AGENT][NEUTRAL] Sure, yes, the new policy number is 0246.
[AGENT][NEUTRAL] 2810. Again, that's 02462810.
[AGENT][NEUTRAL] Effective date is [PII] and it is active at the moment. This is a secondary supplemental plan to the major medical and you need benefits for diagnostic testing and outpatient facility, [PII].
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, and this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer and we have an outpatient maximum of 2500 per covered person per calendar year.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, thank you. Is there any co-insurance or co-pay?
[AGENT][NEUTRAL] No, this is not, um, this is the secondary policy to the major medical. We're not the major medical, um, so there's no deductibles, co-payment or co-insurance. We help with the deductibles, co-payment, and coinsurance from the major medical.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Oh, OK. So for this exam he's having a head and neck soft tissue ultrasound and the co-payment to today is $93.95. Would this plan cover that?
[AGENT][NEUTRAL] It's part of the the uh outpatient benefits correct and the maximum is 2500. We cannot guarantee any payments over the phone, but that is part of the benefits, yes, Miss [PII].
[CUSTOMER][NEUTRAL] OK thank you can I please get a name and reference number?
[AGENT][NEUTRAL] My name is [PII]. That's [PII]. That's initial [PII], and we don't have reference numbers, you can use my name in today's date if you would like.
[CUSTOMER][POSITIVE] Thank you so much have a nice day.
[AGENT][POSITIVE] You're welcome. Do it as so and thank you for calling APL Miss [PII]. Bye bye.
[CUSTOMER][POSITIVE] Bye have a nice weekend.