AccountId: 011433970860
ContactId: 3407fbf1-6d2a-4b8e-baa7-be71ff26f6a3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 163369 ms
Total Talk Time (AGENT): 88040 ms
Total Talk Time (CUSTOMER): 47454 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/30/3407fbf1-6d2a-4b8e-baa7-be71ff26f6a3_20241230T16:04_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Hi, I'm calling to get benefits for our patients.
[AGENT][NEUTRAL] OK, yeah, I can check that if it's for you. uh, what was your name?
[CUSTOMER][NEUTRAL] [PII] is spelled [PII]
[AGENT][NEUTRAL] OK, and [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah it's [PII].
[AGENT][NEUTRAL] OK, thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Uh yeah, it's 02485421.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Um, his name is [PII] and it's [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. So the policy is active. Effective date was [PII], and we'll be needing to look at uh outpatient benefits?
[CUSTOMER][NEUTRAL] Yeah, he's scheduled for an outpatient surgery.
[AGENT][NEUTRAL] OK, of course I will. Got you. OK, so I will let you know verification of coverage is not a guarantee of payment for claims. So as this is a secondary medical policy, it is designed to help with co-pay, deductible and co-insurance after major medical pays. This outpatient benefit is $2500 max per calendar year.
[CUSTOMER][NEUTRAL] Next year.
[CUSTOMER][NEUTRAL] 8500?
[AGENT][NEUTRAL] Um, 2500 per calendar year.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Can you tell me if you use any of that?
[AGENT][NEUTRAL] Uh yes, let me see.
[CUSTOMER][NEUTRAL] Well I mean I guess it won't, well, no calendar year, so July.
[AGENT][NEUTRAL] If it's for next year it would renew yeah but either way he's not used any of that so.
[CUSTOMER][NEUTRAL] OK, yeah, it'll be for um [PII] his surgery.
[AGENT][NEUTRAL] OK, yeah, I'm not showing he's used any and of course by then it should have reset so assuming he doesn't have anything prior to that it should have all of that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Was there anything else I can help you with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, you, I mean, I guess y'all don't need precert or anything, huh?
[AGENT][NEUTRAL] No, um, this policy is very dependent on major medical, so as long as, uh, his primary will pay this policy can.
[CUSTOMER][NEUTRAL] OK, and what was your name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Last name [PII]?
[AGENT][NEUTRAL] A
[CUSTOMER][NEUTRAL] Alright, do y'all do call reference numbers?
[AGENT][NEUTRAL] Yeah, it would just be my first name, last initial, and today's date.
[CUSTOMER][POSITIVE] All right well thank you.
[AGENT][POSITIVE] Yeah, thanks for calling APL. I hope you have a happy [PII].
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.