AccountId: 011433970860
ContactId: 20c26845-8fb8-4f17-ad12-9a45a5cc4d78
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 173759 ms
Total Talk Time (AGENT): 101972 ms
Total Talk Time (CUSTOMER): 55315 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/20c26845-8fb8-4f17-ad12-9a45a5cc4d78_20250117T20:01_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] Last name initials [PII].
[AGENT][POSITIVE] Hi, you [PII]. How can I help you today?
[CUSTOMER][POSITIVE] Yes, I'm calling to see the outpatient benefits for a member.
[AGENT][POSITIVE] OK, I'll be glad to help you. Go and give me a good policy number.
[CUSTOMER][NEUTRAL] Policy number is 02042058ML8.
[AGENT][NEUTRAL] Alright, [PII], thank you for that information. Now while I'm pulling this up, go ahead, give me a good return telephone call number please, sir.
[CUSTOMER][NEUTRAL] [PII] direct line.
[AGENT][NEUTRAL] All right, you will, you [PII], thank you for that information. Now, what is your patient's name and date of birth today?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Well, it looks like he is a dependent child on this medical supplemental plan to show the original effective date.
[AGENT][NEUTRAL] Excuse me, it's [PII] patient is currently active, but I must advise that verification of coverage is not a guarantee of payment on a claim, but you did say you want some type of benefit. Is that correct?
[CUSTOMER][POSITIVE] Yes, outpatient benefits.
[AGENT][NEUTRAL] All right, let me get over to that screen. Let's see.
[AGENT][NEUTRAL] All right, now you list is what we are is the medical supplemental plan. So the only thing that we would pick up and pay on for sickness and injury is anything that is applied towards patient deductible, co-pay, or co-insurance at the primary insurance carrier. Now for outpatient benefit here it's a no pre-cert, no deductible, and they have a $1500 benefit payable per calendar year.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK. And have they
[CUSTOMER][NEUTRAL] You said 1500?
[AGENT][NEUTRAL] Mhm, that is correct per calendar year.
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] Have, would you be able to tell me if they've accumulated any so far for the new calendar year?
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] I don't have any claims as of today. No, sir.
[CUSTOMER][POSITIVE] OK, so they still have the full, OK, thank you so much for all your help today. I have the initial to your last name.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Well, you're so welcome.
[AGENT][NEUTRAL] It's oh, and is that all I can help you with today?
[CUSTOMER][NEUTRAL] And a reference number for this call?
[CUSTOMER][NEUTRAL] Yes, just the reference number for this call.
[AGENT][NEUTRAL] Oh, OK. Well, we do not give reference numbers, [PII], but you can use my name in today's date if you need to do so, OK.
[CUSTOMER][POSITIVE] OK, thank you so much for all your help today.
[AGENT][POSITIVE] Well, you're so welcome. [PII] and thanks for calling APO and you have a great rest of your day, OK?
[CUSTOMER][NEUTRAL] You as well. Bye.
[AGENT][POSITIVE] Thank you. Bye-bye.