AccountId: 011433970860
ContactId: 330928e7-eeb2-4f6f-9697-8d38bb4a320d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 165339 ms
Total Talk Time (AGENT): 82031 ms
Total Talk Time (CUSTOMER): 56514 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/330928e7-eeb2-4f6f-9697-8d38bb4a320d_20250228T18:53_UTC.wav
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[AGENT][NEUTRAL] APL, my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, [PII]. I'm calling for benefits.
[AGENT][NEUTRAL] I can help with benefits, with whom am I speaking, please?
[CUSTOMER][NEUTRAL] [PII] I'm calling from a provider's office.
[AGENT][NEUTRAL] Uh.
[AGENT][NEUTRAL] OK, [PII], thank you very much. And what is that, uh, policy number that we're looking at today, please?
[CUSTOMER][NEUTRAL] Uh, policy number is 02583627ML8.
[AGENT][POSITIVE] Appreciate that. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Uh, [PII] [PII].
[AGENT][NEUTRAL] OK. And the last thing I need is just a callback number in case we're disconnected.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. The policy went into effect on [PII]. It is active. This is a secondary or gap insurance, and it's meant to pick up the deductible, co-payment, or co-insurance for their major medical for in and out of hospital services. So for outpatient hospital, we pick up the deductible, co-payment or co-insurance up to $1250 or for inpatient services, up to $5000 per calendar year, and that's just a verification of the benefits, not a guarantee of payment.
[AGENT][NEUTRAL] Is there anything in particular I can tell you about the policy, any particular place of service or?
[CUSTOMER][NEUTRAL] You said for inpatient services she has $5000 coverage?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And that applies to only deductible coinsurance or out of pocket, not office visits or any ultrasounds or anything like that, right?
[AGENT][NEUTRAL] That's correct, yes. This is, this is strictly for hospitals.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] Um, and then for outpatient is it a separate, um.
[AGENT][NEUTRAL] It's the 1000
[CUSTOMER][NEUTRAL] Be or.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] Yeah, it's, it is separate. It's the $1250. So she went to the emergency room, the ER, um,
[AGENT][NEUTRAL] Urgent care, that sort of thing, that, that is what that is for.
[CUSTOMER][NEUTRAL] In outpatient you said it was 1000. I'm sorry?
[AGENT][NEUTRAL] $1250.
[CUSTOMER][NEUTRAL] OK, got you.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] Um, can I have a reference number for this call?
[AGENT][NEUTRAL] Yes, my name is [PII]. The first letter of my last name is [PII], and we're gonna use that today's date as a reference. Is there anything else at all that I may help with?
[CUSTOMER][NEUTRAL] No, that would be all.
[AGENT][POSITIVE] OK, well, thank you for contacting APR. Have a good day.