AccountId: 011433970860
ContactId: 2bf17d40-8fae-4e51-9575-9905f79b667e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 303000 ms
Total Talk Time (AGENT): 143204 ms
Total Talk Time (CUSTOMER): 97035 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/2bf17d40-8fae-4e51-9575-9905f79b667e_20250610T22:43_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, hi, my name is [PII]. I am calling from the University of Utah Health on a recorded line. Uh, hi, [PII]. Um, actually, I was calling because I need to check uh benefits for a patient.
[AGENT][NEUTRAL] OK, hey, [PII], I can help you. Um, what is your callback number, ma'am, just in case the call is dropped, I can call you right back.
[CUSTOMER][NEUTRAL] Uh, yeah.
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you. And then may I get the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Uh, yeah, OK. Policy number is 024743777.
[CUSTOMER][NEUTRAL] The patient's name is [PII]. Uh, date of birth is [PII].
[AGENT][NEUTRAL] OK, let me look them up real quick.
[AGENT][NEUTRAL] OK, I do show that [PII] does have an active policy with us. The effective date of the policy is [PII].
[AGENT][NEUTRAL] Excuse me, and this is just to verify her benefits. It's not a guarantee of payment. She has a supplemental insurance policy. It's billed secondary to the primary.
[AGENT][POSITIVE] It helps with deductible, co-pay, and co-insurance.
[CUSTOMER][NEUTRAL] OK, uh, 3.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK sorry um.
[AGENT][NEUTRAL] Excuse me?
[CUSTOMER][NEGATIVE] I can hear you well, it's cutting off.
[AGENT][POSITIVE] Oh, I'm sorry.
[CUSTOMER][NEUTRAL] Can you fix your microphone, please?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes. Is that any better for you?
[CUSTOMER][POSITIVE] Yes, much better.
[AGENT][POSITIVE] OK awesome.
[AGENT][NEUTRAL] And this policy helps with deductible, co-pay, and co-insurance.
[AGENT][NEUTRAL] She has an inpatient, um.
[AGENT][NEUTRAL] Calendar year benefit of $3000 and then she also has an outpatient calendar year benefit of the same amount of $3000.
[AGENT][NEUTRAL] Per year.
[CUSTOMER][NEUTRAL] That's the deductible and the out of pocket, right?
[AGENT][NEUTRAL] No, that is.
[AGENT][NEUTRAL] The benefit that helps towards deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] OK. OK, let's see. The deductible is 3000, right?
[AGENT][NEUTRAL] No, she doesn't have a deductible, that's the benefit amount.
[AGENT][POSITIVE] That she gets every year to help with deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] So there is no deductible, no out of pocket, and no coinsurance, right?
[AGENT][NEUTRAL] Correct. This is the secondary insurance.
[CUSTOMER][NEUTRAL] Yes, I know. Um, OK. Uh, are you able to tell me if facility call records?
[AGENT][NEUTRAL] It doesn't go by CPT code. It goes by deductible, co-pay or co-insurance. So after the primary is built, any deductible co-pay or co-insurance, if it's in a covered facility would come to us so that we can pay the benefit.
[AGENT][NEUTRAL] For the insured.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So not, does not require theization as well, right?
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] Hm, I'm confused, uh.
[CUSTOMER][NEUTRAL] Usually, the, the benefits are the deductible on the out of pocket. So, uh, uh, I don't know what you want to, to mean when you say benefit 3000. I, I'm a little confused.
[AGENT][NEUTRAL] She's got $3000 per calendar year to help pay for deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, [PII], um.
[CUSTOMER][NEUTRAL] Are you able to verify if we are in network with this patient plan?
[AGENT][NEUTRAL] Uh, it's not the major medical, wherever she uses her major medical, she can use this insurance also.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So she doesn't have a network.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, [PII], do you have any reference number for this call?
[AGENT][NEUTRAL] Yes, ma'am. You can use my name, [PII], and today's date.
[CUSTOMER][POSITIVE] Got it. Thank you so much. Hope you have a wonderful day.
[AGENT][POSITIVE] You too thank you for calling APL you have a good night bye bye.
[CUSTOMER][NEUTRAL] Bye bye you too.