AccountId: 011433970860
ContactId: 2fd76a6d-ef3b-48f1-aa3c-ade1e9a7e173
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 249470 ms
Total Talk Time (AGENT): 109213 ms
Total Talk Time (CUSTOMER): 46632 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/2fd76a6d-ef3b-48f1-aa3c-ade1e9a7e173_20250529T14:17_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, um, I, uh, I'm just need to verify, uh, benefits on a patient.
[AGENT][POSITIVE] OK, I can help you with benefits. Can I get your name and a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII] and then the phone number is [PII].
[AGENT][POSITIVE] Thank you so much. And do you have the uh policy number, [PII]?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Are you ready for that one?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK. It is 01986382.
[AGENT][NEUTRAL] OK. Let me look that up.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] And can you verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] and then [PII].
[AGENT][POSITIVE] OK, thank you so much.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, it looks like the policy number you gave me is no longer active. It had an effective date of [PII]. The policy lapsed on [PII]. Let me see if she has any other policies with us though.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I am showing one.
[AGENT][NEUTRAL] And are you ready for that new policy number?
[CUSTOMER][NEUTRAL] Um, yes, ma'am, give me just a second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, I am ready now.
[AGENT][NEUTRAL] It's 02.
[AGENT][NEUTRAL] 566-490.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And the effective date for that policy is [PII].
[AGENT][NEUTRAL] And you're wanting benefits on this, is that correct?
[CUSTOMER][POSITIVE] Yes ma'am, yes ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I will say this is a secondary gap policy, um, so we will need an EOB.
[AGENT][NEUTRAL] From the primary insurance showing that they paid partial?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And let me pull up her policy.
[AGENT][NEUTRAL] This is a verification of benefits and not a guarantee of payment.
[AGENT][NEUTRAL] Let me see
[AGENT][NEUTRAL] It looks like [PII] has an inpatient benefit maximum of up to $3000.
[AGENT][NEUTRAL] Per calendar year?
[AGENT][NEUTRAL] In an outpatient benefit maximum of up to $3000 per calendar year. These need to be related to a sickness or an accident, specifically for this policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] Right, and is there any other questions?
[CUSTOMER][NEUTRAL] Um, does she have a group number as well?
[AGENT][NEUTRAL] Let me pull it up.
[AGENT][NEUTRAL] OK, it's 24.
[AGENT][NEUTRAL] 542.
[CUSTOMER][NEUTRAL] OK, alright, that was all I needed.
[AGENT][POSITIVE] All right, thank you for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] Thank you you too.
[AGENT][NEUTRAL] Right, bye.
[CUSTOMER][NEUTRAL] Mm bye bye.