AccountId: 011433970860
ContactId: 378a7fcf-cf8b-4ff1-8591-c7111736924c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 204039 ms
Total Talk Time (AGENT): 110603 ms
Total Talk Time (CUSTOMER): 63137 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/14/378a7fcf-cf8b-4ff1-8591-c7111736924c_20250314T20:47_UTC.wav
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[AGENT][NEUTRAL] Contacting APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, yes, I needed to get benefits for 2 patients, please.
[AGENT][NEUTRAL] I can help with benefits, with whom am I speaking, please?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] Hey [PII], thank you. What is that, uh, policy number that we're looking at today?
[CUSTOMER][NEUTRAL] Um, this is 02493169.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][POSITIVE] I do appreciate that. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you very much. So the policy went into effect on [PII]. It is active. You mentioned benefits. Now, this is a secondary or gap insurance, meant to pick up the deductible, co-payment or co-insurance from a major medical, so they're in and out of hospital benefits on this. Is there anything in particular that I could tell you?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, I needed benefits for outpatient diagnostic studies for an X-ray.
[AGENT][NEUTRAL] Yes, so what we will do is we will pick up the deductible, co-payment or co-insurance for such a service up to $3000 per calendar year. Now that is just a verification of the benefits, not a guarantee of payment. That doesn't look like, uh, any of the benefits have been used for the calendar year [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And that is that that also counts for outpatient studies?
[AGENT][POSITIVE] That's correct, yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, OK, can I have a reference number for this patient, please?
[AGENT][NEUTRAL] Yes, my name is [PII]. The first letter of my last name is [PII]. We're gonna use that today's date as a reference. Now, you said that there was another patient that I could help with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, just one more patient.
[CUSTOMER][NEUTRAL] Um, this one, the policy is 02548739.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth please?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK. Let me make sure I've got this correct. Uh, you said 0254.
[AGENT][NEUTRAL] 873 9.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so the policy went into effect on [PII]. It is active. Now the outpatient benefit for this, um,
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] This particular policy will pay up to $300 per calendar day.
[AGENT][NEUTRAL] Uh, it will pick up the deductible, co-payment, or co-insurance for that amount for, uh, diagnostic services, outpatient hospital, um, outpatient office, uh, services. Now, that is, of course, just a verification the benefit's not a guarantee of payment, but it is a per calendar day benefit, so it's each and every calendar day.
[CUSTOMER][NEUTRAL] Right, so 300 each day.
[AGENT][POSITIVE] A correct, yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Um, OK, right then that, that's all I needed then. Thank you so much.
[AGENT][POSITIVE] OK, well, if there's anything I can help you with, thanks for contacting AP. Have a good day.