AccountId: 011433970860
ContactId: 2262407c-b8e0-4519-8b61-c082d0f924ce
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 157779 ms
Total Talk Time (AGENT): 78876 ms
Total Talk Time (CUSTOMER): 69921 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/2262407c-b8e0-4519-8b61-c082d0f924ce_20250204T15:57_UTC.wav
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[AGENT][NEUTRAL] Contacting APO my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], good morning. I'm provider's office. Uh, my name is [PII]. I have a patient. I need to check the benefits and eligibility for uh this patient.
[AGENT][POSITIVE] OK, cool. I can certainly help with benefits and eligibility. What is that policy number, please?
[CUSTOMER][NEUTRAL] Is 968015.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] It's [PII], [PII].
[AGENT][POSITIVE] I appreciate that. And is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. This is a secondary or gap insurance that went into effect on [PII]. It is active.
[AGENT][NEUTRAL] Now, what we are meant to do um is take up the deductible, co-payment or co-insurance for in and out of hospital settings. Um, so for outpatient services, we will pick up that deductible, co-payment or co-insurance up to $500 per calendar day. and obviously that's just a verification benefit it's not a guarantee of payment. Is there anything else that I can tell you about the policy? Anything in particular?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK, yeah, because he, he has a nuclear stress test in the office.
[CUSTOMER][NEUTRAL] But uh because um the copay for Cigna is 500.
[CUSTOMER][NEUTRAL] And he said the American this time gap insurance is paid for that.
[AGENT][NEUTRAL] OK, for uh, uh, a physician's office. Is that correct?
[CUSTOMER][NEUTRAL] Yeah, physician, especially physician office, yeah, and nuclear stress test.
[AGENT][NEUTRAL] Right. So what we do is we pick up the deductible, co-payment or co-insurance for in and out of hospital only. Um, so there's no, uh, there are no benefits for uh a physician's office.
[CUSTOMER][NEUTRAL] Oh, OK, that's for hospital office. Oh, hospital only. OK.
[AGENT][NEUTRAL] That
[AGENT][POSITIVE] That's correct, yes.
[CUSTOMER][NEUTRAL] No office. Oh, OK, that's a good question, yeah, because he said, no, that's, is everything is covered for the for the public life insurance. Oh, OK, no office. Perfect, 500.
[AGENT][MIXED] Right, yes, yes, it's just hospital, um, and, uh, so if it's, it's for a hospital setting, then we're good. Otherwise, um, it doesn't cover that.
[CUSTOMER][POSITIVE] Perfect. [PII], you have a call reference number?
[AGENT][NEUTRAL] Yes, my name is [PII]. The first letter of my last name is [PII]. We're gonna use that today's date as a reference. Is there anything else at all that I may help with?
[CUSTOMER][POSITIVE] That's it. Thank you.
[AGENT][POSITIVE] OK, well thank you for contacting AP have a good.