AccountId: 011433970860
ContactId: 31904b59-033a-4555-a35c-b10e40096e0c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 226460 ms
Total Talk Time (AGENT): 86714 ms
Total Talk Time (CUSTOMER): 90183 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/31904b59-033a-4555-a35c-b10e40096e0c_20250527T19:50_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, yes, [PII], my name is [PII], first initial of my last name is [PII]. Uh, we had a patient bring in one of y'all's cards and I just need to verify eligibility and benefits on it.
[AGENT][NEUTRAL] Oh, OK, well, I can definitely help you with the eligibility and benefits. And [PII], um, may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Yes, of course, uh, callback number is [PII].
[CUSTOMER][NEUTRAL] And then the policy number is 02506284.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So I am showing the policy is active. It's been effective since [PII].
[AGENT][NEUTRAL] And this is their secondary um gap insurance for medical, um, so we apply to the co-pay, deductible and co-insurance of covered charges after primary.
[AGENT][NEUTRAL] Um, are you all considered outpatients?
[CUSTOMER][NEUTRAL] OK, and is any.
[CUSTOMER][NEUTRAL] Yes, we are outpatient. We do show his uh primary Aetna. Uh, do y'all require any type of authorization or anything else on the or for the patient's plan in order for it to pay?
[AGENT][NEUTRAL] Um, no, not for the secondary. Um, we would just process, let me see for outpatient, the max is 7500 per calendar year.
[CUSTOMER][NEUTRAL] You said 7000?
[AGENT][NEUTRAL] Um, $7500 per calendar year.
[CUSTOMER][NEUTRAL] And how much are you showing that they've used so far?
[AGENT][NEUTRAL] Let's see.
[AGENT][NEGATIVE] Um, none of the benefits have been used for [PII].
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] With all of it still remaining and then I have y'all uh billing address is [PII].
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] Awesome and is there any sort of network or anything with this or is it just as long as the primary pays then y'all take it into consideration?
[AGENT][NEUTRAL] Um, yeah,
[AGENT][NEUTRAL] Not for secondary, um, we have our own benefits, but we can't apply unless primary applies.
[CUSTOMER][NEUTRAL] OK, and your name again?
[AGENT][NEUTRAL] My name is [PII]. The first initials of my last name is [PII].
[CUSTOMER][NEUTRAL] And is there a reference number for today's call?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date, um, and the first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] OK. Oh, OK, OK, and
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][POSITIVE] Awesome thank you so much and you have a great day.
[AGENT][POSITIVE] You're very welcome, [PII]. Was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] No ma'am, that's gonna be all.
[AGENT][POSITIVE] Alright, well, thanks for calling APL and I hope you have a great day.
[CUSTOMER][NEUTRAL] Mm bye.