AccountId: 011433970860
ContactId: 166c6901-53a4-45e6-8e87-d06f55d495f4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 225080 ms
Total Talk Time (AGENT): 113364 ms
Total Talk Time (CUSTOMER): 75052 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/10/166c6901-53a4-45e6-8e87-d06f55d495f4_20250410T15:38_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Toy, hi, I'm calling from NMed. Um, I need benefits on a patient please.
[AGENT][POSITIVE] OK, I can help you with benefits. Can I please get your name and your callback number?
[CUSTOMER][NEUTRAL] [PII] [PII].
[CUSTOMER][NEUTRAL] And is your name [PII]?
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][POSITIVE] Why, OK, thank you.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] You're very welcome. And then Miss [PII], what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Um, it's [PII]. Date of birth [PII], and the policy number is 02385301.
[AGENT][NEUTRAL] OK, let me look up his policy real quick.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're very welcome.
[AGENT][NEUTRAL] So I do show that [PII] does have an active policy. His effective date is [PII].
[AGENT][NEUTRAL] Just to verify his benefits, it's not a guarantee of payment. Uh, he has a supplemental insurance policy that's billed secondary to the primary.
[AGENT][NEUTRAL] This policy helps with deductible, co-pay and coinsurance.
[AGENT][NEUTRAL] So he has an inpatient calendar year benefit amount.
[AGENT][NEUTRAL] Of
[AGENT][NEUTRAL] Through
[AGENT][NEUTRAL] $750.
[CUSTOMER][NEUTRAL] Uh, I'm sorry, we're breaking up. What was that again?
[AGENT][NEUTRAL] And then you
[AGENT][NEUTRAL] It was 3700 $3750.
[CUSTOMER][NEUTRAL] I'm sorry we're breaking up.
[CUSTOMER][NEUTRAL] T
[CUSTOMER][NEUTRAL] Calendar year.
[AGENT][NEUTRAL] Inpatient benefit.
[CUSTOMER][NEUTRAL] Max
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Inpatient, what about outpatient?
[AGENT][NEUTRAL] Outpatient, he also has a $3750 calendar year benefit.
[CUSTOMER][NEUTRAL] OK, calendar calendar year benefit, OK.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] To go towards deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] To go towards.
[CUSTOMER][NEUTRAL] Deductible.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] And copay, right?
[AGENT][NEUTRAL] Yeah, deductible, co-pay or co-insurance. Now, he does have um an outpatient calendar year deductible.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, for accident or sickness.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Which is $250.
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] $250 deductible for sickness.
[AGENT][NEUTRAL] Or accident.
[CUSTOMER][NEUTRAL] Or accident.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, and that's calendar year?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, is there a reference number?
[AGENT][NEUTRAL] Yes, you can use my name, [PII]
[AGENT][NEUTRAL] And today's date.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you so much, [PII]. You have a great day.
[AGENT][POSITIVE] Miss [PII], you have a wonderful day too. Is that all I can help you with before we go?
[CUSTOMER][NEUTRAL] That's it.
[AGENT][POSITIVE] OK, well, have a great day and thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][NEUTRAL] Um