AccountId: 011433970860
ContactId: 28f0a4d0-b9db-4630-840a-f100920cedcf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 221759 ms
Total Talk Time (AGENT): 102753 ms
Total Talk Time (CUSTOMER): 74385 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/28f0a4d0-b9db-4630-840a-f100920cedcf_20250221T15:45_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from Geisinger Medical Center, hoping you could help me with some eligibility and benefits for a member.
[AGENT][POSITIVE] Sure, I can help you with both the eligibility and the benefits. And [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][POSITIVE] Yes, it's [PII]. That's correct.
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yes, it's 02441989.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're welcome. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] I have [PII], [PII].
[AGENT][NEUTRAL] Thank you, and all the information provided is a verification of benefits, not a guarantee of payment. So I'm actually showing this particular policy is no longer active. It was effective from [PII].
[AGENT][NEUTRAL] But there is an active policy. Let me get you that policy number. Hold on one moment.
[CUSTOMER][POSITIVE] OK, great.
[AGENT][NEUTRAL] So this policy has been active since [PII], um, and it's 2579213.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] 2579213. OK, so, um.
[CUSTOMER][NEUTRAL] It's the same plan.
[AGENT][NEUTRAL] Let me see if there were any changes.
[AGENT][NEUTRAL] Um, no, this is a different plan type, but I can assist you with the benefits.
[CUSTOMER][NEUTRAL] OK, thank you. Um, he's coming in for an outpatient surgical procedure.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, actually, it's a colonoscopy.
[AGENT][NEUTRAL] Alright, so the policy will pay for outpatient up to $1000 per calendar day. That does include diagnostic testing um in a hospital outpatient room, uh, facility, MRI facility, or physician office.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is there any max out of pocket or anything?
[AGENT][NEUTRAL] No, um, not for the secondary. So, um, we just have the $1000 per day, we'll pay for or we could pay towards the copay, deductible and co-insurance after primary.
[CUSTOMER][NEUTRAL] OK, so you're showing that he is a primary insurance. Do you show what it is?
[AGENT][NEUTRAL] Uh, sure, hold on, let me see.
[CUSTOMER][NEUTRAL] Cause I'm showing, I'm showing that his, he had United Healthcare, but I'm showing that term as at the end of the year.
[AGENT][NEUTRAL] Um, this is secondary to Cigna.
[CUSTOMER][POSITIVE] OK, great.
[CUSTOMER][NEUTRAL] And you said it pays up to $1000 per day, is that unlimited days? If it's like an inpatient?
[AGENT][NEUTRAL] Well, no, inpatient benefits are different. This is just for outpatient.
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Do you give reference numbers?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name at today's date, and again, that's [PII] initial to my last name is [PII], and then today's date.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][POSITIVE] All right, thank you so much for the information. I appreciate your time.
[AGENT][POSITIVE] You're welcome, [PII]. Was there anything else I can help with?
[CUSTOMER][POSITIVE] No, that's all I needed. Have a good day.
[AGENT][POSITIVE] Alright, thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.