AccountId: 011433970860
ContactId: 44e92c12-811f-4588-904a-e518b7cb27ee
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 207490 ms
Total Talk Time (AGENT): 115563 ms
Total Talk Time (CUSTOMER): 66121 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/30/44e92c12-811f-4588-904a-e518b7cb27ee_20250430T16:48_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][POSITIVE] Hi, my name is [PII]. I'm with Heart of the Rockies Regional Medical Center and I'm trying to get uh benefits for uh a patient of ours.
[AGENT][NEUTRAL] OK, I will be glad to help you, but I am so sorry I did not catch your name.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] OK, [PII], thank you for that, [PII]. Now go ahead and give me a good policy number, please, ma'am.
[CUSTOMER][NEUTRAL] 01847164.
[AGENT][NEUTRAL] Alrighty, [PII], thank you for that. Now while I'm pulling this up, go ahead and give me a good return telephone call number please, ma'am.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Alrighty, [PII], thank you for all that information. Now, your patient's name and date of birth today, please?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] Alright, thank you for that information. [PII] looks like [PII] is a dependent on this medical supplemental plan. I do show the original effective date is [PII] current policy is active, but I must advise that verification of coverage is not a guarantee of payment on the claim, but you did say you want some type of benefit. Is that correct?
[CUSTOMER][NEUTRAL] Yes. She is having an outpatient surgery. What kind of coverage does she have?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me get that benefit pack pulled up. OK, now, of course, what we are, [PII], is just her medical supplemental plan. So the only thing we will pick up and pay on is anything for sickness and injury that is applied towards her deductible, co-pay, or co-insurance at her primary insurance carrier.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And her outpatient benefit here is going to be a zero deductible, no pre-cert, and she has a $1500 benefit payable per calendar year under this supplemental plan.
[CUSTOMER][NEUTRAL] OK, so the plan will only cover $1500.
[AGENT][POSITIVE] Correct. That is her max benefit.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So if her out of pocket cost is more than $1500 it will not cover, correct?
[AGENT][NEUTRAL] Correct, that is correct. Her max is $1500 here.
[CUSTOMER][NEUTRAL] All right, and do you have a reference number for this call?
[AGENT][NEUTRAL] Well, is that all that I can help answer for you today, [PII]?
[CUSTOMER][NEUTRAL] Yeah, that covers my question.
[AGENT][NEUTRAL] Well, yes, ma'am, but we don't give reference number, [PII], but you can use my name in today's date if you need to do so. And my name is [PII], spelled [PII]
[CUSTOMER][POSITIVE] All right, perfect. Thank you so much for your help today.
[AGENT][POSITIVE] Yes ma'am and thank you for calling APO [PII]. You have a great day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thank you, ma'am. Bye-bye.
[CUSTOMER][NEUTRAL] Mhm. Bye-bye.