AccountId: 011433970860
ContactId: 27eed968-cc70-42a1-9ecd-208fc06263dc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 163429 ms
Total Talk Time (AGENT): 99938 ms
Total Talk Time (CUSTOMER): 57120 ms
Interruptions: 1
Overall Sentiment: AGENT=1.9, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/27eed968-cc70-42a1-9ecd-208fc06263dc_20250516T16:06_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] Uh, yes, ma'am. My name is [PII]. I'm calling with Prisma Health General Surgery. I am just calling to verify eligibility and benefits for a patient.
[AGENT][POSITIVE] OK, [PII], I'll be glad to help you. Go ahead and give me a good policy number.
[CUSTOMER][NEUTRAL] Yeah it's 02521787.
[AGENT][NEUTRAL] All right, [PII], thank you for that. Now, while I'm pulling this up, go ahead and give me a good return telephone call number, please, ma'am.
[CUSTOMER][NEUTRAL] Yes, ma'am. It's [PII].
[AGENT][POSITIVE] Alrighty, [PII], thank you so much for all that information now. Uh, your patient's name and date of birth today.
[CUSTOMER][NEUTRAL] Uh-huh. [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Alright, thank you so much for all that information, [PII]. I mean, uh, [PII], looks like Cheryl is the insured on this medical supplemental plan. This show the original effective date as [PII]. She is current and active, but I must advise that verification of coverage is not a guarantee of payment of a claim, but you did say you won't benefits.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, ma'am, if you have them, so this would be a supplemental policy for her just trying to see how much you guys cover as the secondary.
[AGENT][NEUTRAL] OK, what exact benefit are you needing?
[CUSTOMER][NEUTRAL] Um, she's, so she's here today for just an office visit for specialist office visit.
[AGENT][NEUTRAL] OK, let's see what she has. OK, and of course, uh we are just her 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 her deductible, co-pay or co-insurance at her primary insurance carrier.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And of course, let's see, it looks like her benefits here, she don't have anything, no office benefits uh covered here at all. The only thing she's gonna have here is anything done outpatient.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Or inpatient or lab, but yeah, nothing, nothing in the doctor's, yeah, nothing in the doctor's office is covered here at all either way.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, so like hospital type stuff.
[CUSTOMER][POSITIVE] OK, very good. Perfect. Well, um thank you so much for your help. Is there a call reference number for today?
[AGENT][NEUTRAL] No, ma'am. And is that all that I can help answer for you today, [PII]?
[CUSTOMER][POSITIVE] No, ma'am. That'll be all. Thank you.
[AGENT][POSITIVE] OK, yes ma'am, and thanks for calling APO [PII]. Have a good day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thank you, ma'am. Bye-bye.
[CUSTOMER][NEUTRAL] Mm bye-bye.