AccountId: 011433970860
ContactId: 2dcddeec-f944-4e0d-96ac-9a128a97ce15
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 282029 ms
Total Talk Time (AGENT): 84363 ms
Total Talk Time (CUSTOMER): 87121 ms
Interruptions: 2
Overall Sentiment: AGENT=1.2, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/2dcddeec-f944-4e0d-96ac-9a128a97ce15_20250428T17:00_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, good afternoon, Miss [PII]. My name is [PII], and I'm calling from Mount Sinai Medical Center calling to verify, um, gap insurance for one of your, uh, insured please.
[AGENT][NEUTRAL] Yes, of course. Do you have the policy number on you?
[CUSTOMER][NEUTRAL] Yes ma'am, I surely do. You ready? It's uh it's uh um it is 02493478 M as in mother, L as in Lima, the number 8.
[AGENT][POSITIVE] I'm ready.
[AGENT][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] And then [PII], what's a good call back number in case our call gets dropped?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And then the patient's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Ms. [PII], uh, [PII].
[AGENT][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] So it looks like this policy is currently active. The effective date is [PII].
[AGENT][NEUTRAL] And this is a meddling policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And what's her coverage because she has a very high deductible, and I want to know, does it cover her deductible for her mammogram and her ultrasound because her deductible is $5000 and her payment today will be $759 the contractor rate.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me pull up her benefits really quick.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And this is, is this in an office setting?
[CUSTOMER][NEUTRAL] No, this is a facility. It's outside our medical center. If you need my tax ID, I'll give it to you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, that's OK.
[CUSTOMER][NEUTRAL] Maybe they only sent me the mammogram.
[CUSTOMER][NEUTRAL] You heard me?
[CUSTOMER][NEUTRAL] OK, she didn't, she didn't even need it for that because she just having a screening.
[CUSTOMER][POSITIVE] Thank you. I'm just waiting. She's checking. I'm so sorry.
[AGENT][NEUTRAL] OK, so this is not a guarantee of payment. It's just a ver verification of coverage. So it looks like.
[AGENT][NEUTRAL] They do have outpatient benefits for an outpatient treatment.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] And an outpatient facility, and that outpatient benefit max is 5300 per covered person per calendar year.
[CUSTOMER][NEUTRAL] Has she used any money yet?
[AGENT][NEUTRAL] Let me double check for you.
[AGENT][NEUTRAL] She has not used anything as of this year.
[CUSTOMER][POSITIVE] OK, thank you so much, Ms. [PII]. OK, thank you. Thank you. You have Miss [PII], I need the initial of your last name.
[AGENT][POSITIVE] Yeah, of course, you're welcome. Yeah, is there anything else I can help you with?
[AGENT][NEUTRAL] Yes, ma'am. It's [PII]
[CUSTOMER][NEUTRAL] And Miss [PII], can you give me a reference number please?
[AGENT][NEUTRAL] Yes, so it's my first name, [PII], last initial [PII] and then today's date.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] Thank you so much. You have a great day. Thank you thank you bye bye.
[AGENT][POSITIVE] Of course, thanks for calling ATL mhm bye.