AccountId: 011433970860
ContactId: 183f1ba3-ecc0-4f9c-bcf8-d4c279ca5cf4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 177509 ms
Total Talk Time (AGENT): 116439 ms
Total Talk Time (CUSTOMER): 38358 ms
Interruptions: 1
Overall Sentiment: AGENT=1.6, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/183f1ba3-ecc0-4f9c-bcf8-d4c279ca5cf4_20250605T18:34_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from Mount Sinai Medical Center. I need to verify coverage please for one member.
[AGENT][POSITIVE] All right, [PII], I'll be glad to help you. Go and give me your policy number, please, ma'am.
[CUSTOMER][NEUTRAL] Policy number 02478743ML8.
[AGENT][POSITIVE] All right, thank you so much for all that information, [PII]. Now while I'm pulling this up, go ahead and give me a good return telephone call number please, ma'am.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Alrighty, thank you. All that information, [PII]. Now your patient's name and date of birth today, please, ma'am.
[CUSTOMER][NEUTRAL] Patient is [PII] [PII].
[AGENT][NEUTRAL] Alrighty, thank you for that information. Looks like [PII] is the insured on this medical supplemental plan. I do show the original effective date is [PII]. Patient is current and active, but I must advise that verification of coverage is not a guarantee of payment on the claim, but you did say you want some type of benefit. Is that correct, [PII]?
[CUSTOMER][NEUTRAL] That is correct for outpatient diagnostic services.
[AGENT][NEUTRAL] Alrighty, let me get that benefit pack pulled up. Let's see what they have. And of course, [PII], what we are is uh just a medical supplemental plan. So the only thing that we would pick up and pay on is anything for sickness and injury that is applied towards that patient's deductible, co-pay, or co-insurance at their primary insurance carrier. Nothing routine here is covered no matter what. Now the outpatient benefit here is going to be a zero deductible.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] No pre-cert and they have $300 payable per calendar day benefit here.
[CUSTOMER][NEUTRAL] 600.
[CUSTOMER][NEUTRAL] OK. And just the claims address.
[AGENT][NEUTRAL] And all claims come to APL claims department.
[AGENT][NEUTRAL] And we're at [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that is in [PII].
[AGENT][NEUTRAL] And our zip is [PII].
[CUSTOMER][POSITIVE] Thank you so much. You've been very helpful. Have a wonderful day.
[AGENT][POSITIVE] Oh, yes, ma'am. Is that all that I can help you with today?
[CUSTOMER][POSITIVE] That is all thank you so much I appreciate it bye bye.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] Well, thank you, [PII], for calling APO. Have a good day. Bye-bye.
[CUSTOMER][NEUTRAL] Bye-bye.