AccountId: 011433970860
ContactId: 33b9478a-e318-4da4-bacc-37527528828e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 215220 ms
Total Talk Time (AGENT): 81868 ms
Total Talk Time (CUSTOMER): 91764 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/33b9478a-e318-4da4-bacc-37527528828e_20250207T14:24_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII]. I'm calling from Minor dermatology in regards to a, uh, patient.
[CUSTOMER][NEUTRAL] Um, I'm calling to verify their benefits.
[AGENT][NEUTRAL] You said you're calling to verify. I'm sorry, the phone is breaking up.
[CUSTOMER][NEUTRAL] The this patient's benefits who is currently here.
[AGENT][POSITIVE] Oh, OK, I can help you.
[AGENT][NEUTRAL] OK, I can help you with the eligibility and benefits, and [PII], may I have a good contact number in case we're disconnected and then the policy number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, that would be.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Hi, good morning.
[AGENT][POSITIVE] Thank you and the policy number whenever you're ready.
[CUSTOMER][NEUTRAL] I have 02581443 M like Melissa, L like Larry.
[CUSTOMER][NEUTRAL] 8.
[AGENT][NEUTRAL] Thank you for that. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] First name is [PII]. Last name is [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, and I am showing the policy is active. It's been effective since [PII].
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Sorry, one second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm, effective date. What's the effective date?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Do they have a specialist copay or deductible or?
[AGENT][NEUTRAL] Um, this is their secondary insurance, so we pay towards the copay, deductible and co-insurance of covered charges after primary. For outpatients, the benefit is up to $750 per calendar year. Did you want me to see if any of the $750 has been used?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 6
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEGATIVE] You're welcome and so far for this year, none of the benefits have been used.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And 1 2nd.
[CUSTOMER][NEUTRAL] Sorry, just give me one quick second.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes, I'm here.
[CUSTOMER][NEUTRAL] Sorry, is it, uh, HMO, PPO or POS or?
[AGENT][NEUTRAL] Neither is a secondary insurance, um, so their primary would hold the network.
[CUSTOMER][NEUTRAL] There.
[CUSTOMER][NEUTRAL] OK, so just to confirm, they have a $750 deductible, um, which none of them has been.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] It's not a deductible. They have $750 to use towards outpatient expenses per year for their secondary insurance.
[CUSTOMER][NEUTRAL] OK, sorry, one second, let me check my notes.
[CUSTOMER][NEUTRAL] OK, and I believe that will be all for today.
[AGENT][POSITIVE] Alrighty, well, thank you so much for calling APL [PII]. I hope you have a great weekend.
[CUSTOMER][POSITIVE] Thank you you as well bye bye.
[AGENT][POSITIVE] Thank you. Bye bye.