AccountId: 011433970860
ContactId: 349db246-e0c0-41ba-9e55-9b005a59b117
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 226490 ms
Total Talk Time (AGENT): 106407 ms
Total Talk Time (CUSTOMER): 82269 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/349db246-e0c0-41ba-9e55-9b005a59b117_20250219T21:34_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] Hi [PII], my name is [PII]. I'm calling from Minors dermatology. I was hoping to speak with you about eligibility for a patient.
[AGENT][NEUTRAL] Sure, I can help you with the eligibility. And [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] 954.
[CUSTOMER][NEUTRAL] 9877512 and the policy for the patient?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I have 02027752 M as in Mary, L as in Larry 8.
[AGENT][NEUTRAL] Thank you for that. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII], it's [PII]
[AGENT][NEUTRAL] And date of birth?
[CUSTOMER][NEUTRAL] Um, date of birth is, sorry.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So I'm actually showing the policy number you gave is no longer active. Um, it was effective from [PII], but there is an active policy number. Um, it became effective on [PII], and that's 248.
[CUSTOMER][POSITIVE] Good.
[CUSTOMER][NEUTRAL] Hello
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Oh, hold on one second, 248.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm. 1553.
[CUSTOMER][NEUTRAL] Oh well I didn't see it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And that you said became effective as of [PII]?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Just have to update my stuff here.
[AGENT][POSITIVE] Mm, take your time.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] [PII]. OK, um, is there a co-pay?
[AGENT][NEUTRAL] Um, hold on one moment.
[CUSTOMER][POSITIVE] Take your time.
[AGENT][NEUTRAL] So there's no co-pay. This is their secondary insurance, so this policy is second to
[AGENT][NEUTRAL] Humana. Um, so we pay towards the copay, deductible and co-insurance of covered charges after primary. Um, would you all be considered outpatient?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] So for outpatient, the policy would pay, hold on one moment.
[AGENT][NEUTRAL] Um, the policy would pay $6500 per person, um, per calendar year. There's no deductible.
[CUSTOMER][NEUTRAL] I'm sorry, the policy pays 6000 how much?
[AGENT][NEUTRAL] $6500 per calendar year for outpatient services.
[CUSTOMER][NEUTRAL] Our calendar year OK.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Um, and then is there a reference for this call, a reference number?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. Again, that's [PII], first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect thank you so much for your help.
[AGENT][NEUTRAL] And again, just
[AGENT][NEUTRAL] You're welcome. And again, just for the call, all the information provided was a verification of benefits, not a guarantee of payment. And was there anything else I can assist you with today, [PII]?
[CUSTOMER][POSITIVE] No that was it thank you so much.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] You as well bye bye.
[AGENT][POSITIVE] Thank you bye bye.