AccountId: 011433970860
ContactId: 31001987-dfe7-4ac1-b4e8-b74d93450363
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 175240 ms
Total Talk Time (AGENT): 68071 ms
Total Talk Time (CUSTOMER): 69021 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/12/31001987-dfe7-4ac1-b4e8-b74d93450363_20250212T20:15_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm just calling to verify eligibility and benefits for a um for a patient for this insurance.
[AGENT][POSITIVE] Sure, I can assist you with that. Can I have a callback number for you?
[CUSTOMER][NEUTRAL] Yes, my direct number [PII].
[AGENT][NEUTRAL] What is that policy number?
[CUSTOMER][NEUTRAL] I have 02476613.
[AGENT][NEUTRAL] And what was your name? I apologize.
[CUSTOMER][NEUTRAL] That's OK, it's [PII].
[AGENT][NEUTRAL] [PII], could you verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, um, it's [PII], [PII].
[AGENT][NEUTRAL] You're calling to verify benefits and eligibility for outpatient inpatient office visit?
[CUSTOMER][NEUTRAL] For outpatient hospital?
[AGENT][NEUTRAL] This member's policy has been active since [PII] and is currently active.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The member has outpatient benefits of $1000 per calendar year, and this is not a guaranteed benefits, just a disclaimer of the policy's coverage.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] Mhm mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Any copay?
[AGENT][NEUTRAL] This is not a gap. This is not a primary insurance. This is a gap insurance.
[CUSTOMER][NEUTRAL] Oh, what does that mean a gap insurance?
[AGENT][NEUTRAL] I mean this is a secondary insurance that assists the primary insurance with the deductible, co-pay and co-insurance for services covered under the policy.
[CUSTOMER][NEUTRAL] Oh, OK, OK. Cause patient, it looks like they have Medicaid.
[CUSTOMER][NEUTRAL] Um, but Medicaid will never be primary, that's weird.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Do you know?
[AGENT][NEUTRAL] I gotta have another insurance because this is a gap insurance and we're not a gap insurance to a Medicaid or any type of government assistance program.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Oh, OK, OK. So gap insurance. Oh, see, I learned something new.
[AGENT][NEUTRAL] So you have to reach out to the insurer to verify what's their primary insurance because it sounds like they have 3 of them.
[CUSTOMER][NEUTRAL] Never knew that. OK, no problem. Yeah. Mhm.
[CUSTOMER][POSITIVE] 3. Yes, got it. Yeah, the, they have something else. OK, no problem. Thank you for that. And just a um reference number for this call.
[AGENT][NEUTRAL] We don't provide reference numbers, however, you can use my name in today's date as a reference.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect. Thank you so much. Have a great day.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. You have a great one as well. Goodbye.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You too. Bye.