AccountId: 011433970860
ContactId: 19587e10-c35e-4fbd-b8d8-d65d57eff648
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 130679 ms
Total Talk Time (AGENT): 86976 ms
Total Talk Time (CUSTOMER): 32581 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/27/19587e10-c35e-4fbd-b8d8-d65d57eff648_20250227T19:04_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Contacting APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, I'm calling to verify your patient's eligibility and benefits.
[AGENT][NEUTRAL] I can help with eligibility and benefits. With whom am I speaking, please?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] [PII]? OK, thank you. What's that policy number we're looking at today?
[CUSTOMER][NEUTRAL] I have 016118887.
[CUSTOMER][NEUTRAL] [PII], sorry, [PII].
[AGENT][NEUTRAL] Thank you, and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] I appreciate that. If I could have a callback number in the event that we're disconnected?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] Thank you. Um, Lady, the policy went into effect on [PII]. It is current. Now, this is a secondary or gap insurance and it's meant to pick up the deductible, co-payment or co-insurance for in and out of hospital settings, as well as treatment within a physician's office, cancer treatment, durable medical. So for the outpatient services, we will pick up the deductible, co-payment or co-insurance up to $1500 per calendar year.
[AGENT][NEUTRAL] Or outpatient or excuse me, inpatient benefits for $2500 per calendar year. Obviously, that's just a verification of the benefits, not a guarantee of payment. It doesn't look like any of those benefits have been used at all for the calendar year [PII].
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um, for a specialist office visits.
[AGENT][NEUTRAL] Now, the office visits um are a little bit different. Uh, let's see here. Those, um, it's treatment within the physician's office that is normally covered. The uh office visit is not. So treatment within the physician's office is covered with the, the office visit co-pay is not.
[CUSTOMER][NEUTRAL] Oh, OK, I just wanted to be sure, thank you, and I can, so can I get a reference number?
[AGENT][NEUTRAL] Yes, it's [PII], and the first letter of my last name is [PII], and we're gonna use that today's date as a reference. Is there anything at all that I can help with besides this?
[CUSTOMER][POSITIVE] That'll be all thank you.
[AGENT][POSITIVE] Thanks for contacting APL. Have a good day. Thank you.