AccountId: 011433970860
ContactId: 3f0fef23-5f68-403c-bdff-c9aa07f4e438
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 258660 ms
Total Talk Time (AGENT): 108960 ms
Total Talk Time (CUSTOMER): 119469 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/3f0fef23-5f68-403c-bdff-c9aa07f4e438_20250221T16:23_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Good morning, [PII]. How are you?
[AGENT][POSITIVE] I'm doing well how are you?
[CUSTOMER][NEUTRAL] I'm doing well, thank you for asking. My name is [PII] calling from Jackson Memorial Hospital. I am checking to see if a patient, um.
[CUSTOMER][NEUTRAL] Secondary gap insurance is active and if so, um, does it cover her?
[CUSTOMER][NEUTRAL] Payment towards her deductible.
[AGENT][NEUTRAL] Sure, OK, we could check that eligibility and benefits. Um, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Yes, I do. That is 023.
[CUSTOMER][NEUTRAL] 62419 M as in Mary, L as in Lima number 7.
[AGENT][NEUTRAL] Alright, thank you. And uh what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Yet, or, yeah, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. Uh, so this policy actually terminated [PII]. If you'll give me one moment, I'll see if they have one that's active, might just be a different policy number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, they do have one that is currently active. Uh, let me know when you're ready I can give you that policy number.
[CUSTOMER][NEUTRAL] So it's the same company but different number.
[AGENT][NEUTRAL] Right, yeah, so this one's effective date just picked up where that one left off, um, as [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, go ahead with that policy number, please.
[AGENT][NEUTRAL] Sure, that's 02493426.
[CUSTOMER][NEUTRAL] I repeat 02493426.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Correct. And so as this is a secondary medical policy, it is designed to help with co-pay, deductible and co-insurance after major medical pays, um, was this for an outpatient?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, outpatient, um, hospital, she's coming in for follow up visit along with a breast ultrasound.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Got you. OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims, so the outpatient benefit is on a per calendar day basis. It pays up to $750 per calendar day.
[CUSTOMER][NEUTRAL] How much it pays.
[AGENT][NEUTRAL] $750 max per calendar day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So that's mean it's we'll take care of her 250 copay that she has here with us.
[AGENT][NEUTRAL] It does go towards co-pay, deductible and co-insurance, yes.
[CUSTOMER][NEUTRAL] Mm that's a copay.
[CUSTOMER][NEUTRAL] Um, deductible and coinsurance.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 750 max per calendar day.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, so this plan that she has, it affects also 04 or 1 of 24.
[AGENT][NEUTRAL] Yes, that was this policy's effective date.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, alright, what is your name again and if I could get a reference number, please.
[AGENT][NEUTRAL] Sure, reference number would just be my first name, last initial, and today's date. Uh, so my name is spelled [PII] last initial is [PII], and was there anything else I could help you with?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] today's date. No, ma'am, that's it. Thank you so very much. Enjoy the rest of your day. Have an awesome weekend.
[AGENT][NEUTRAL] Of course.
[AGENT][POSITIVE] Of course, thanks for calling I feel you too. Thank you for reminding me actually.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][POSITIVE] Take care. Bye-bye.
[AGENT][NEUTRAL] You too bye bye.
[CUSTOMER][NEUTRAL] Alright bye bye.