AccountId: 011433970860
ContactId: 47deee39-99ac-402b-8a80-b8b141bafdee
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 587619 ms
Total Talk Time (AGENT): 132922 ms
Total Talk Time (CUSTOMER): 132286 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/11/47deee39-99ac-402b-8a80-b8b141bafdee_20250611T17:20_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Oh hi, my name is uh [PII] calling from provider office.
[CUSTOMER][NEUTRAL] I am looking for eligibility and benefits.
[AGENT][POSITIVE] May I have your name again? I'm so sorry.
[CUSTOMER][NEUTRAL] May I have your name again? Yes, [PII]
[AGENT][POSITIVE] Thank you, and your callback number?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Thank you. What is the policy number?
[CUSTOMER][NEUTRAL] Yes, the policy number is 1851715.
[AGENT][NEUTRAL] OK, let me just repeat that to you, please, [PII], I have that as 1851715. Is that correct?
[CUSTOMER][NEUTRAL] Can you please repeat?
[AGENT][NEUTRAL] 1851715.
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] Thank you. Verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Yeah, patient's name is uh [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you for the verification process, [PII]. You're calling to verify eligibility only, is that correct?
[CUSTOMER][POSITIVE] Thank you for the verification process.
[CUSTOMER][NEUTRAL] Uh eligibility and benefits.
[AGENT][NEUTRAL] OK, I can help with both. The member shows effective as of [PII]. This policy shows active.
[AGENT][NEUTRAL] Would you need inpatient or outpatient benefits today?
[CUSTOMER][NEUTRAL] Outpatient.
[AGENT][NEUTRAL] OK, please note verification of benefits provided does not guarantee payment. We will pay up to $2000 for the calendar year.
[CUSTOMER][NEUTRAL] What is the plan types?
[AGENT][NEUTRAL] This is a supplemental medical policy.
[CUSTOMER][NEUTRAL] OK, and uh it's a 100% covered, right?
[AGENT][NEUTRAL] We pay up to $2000 for outpatient services covered.
[CUSTOMER][NEUTRAL] If a patient has a primary, uh, Aetna commercial plan will cover left of the amount.
[AGENT][NEUTRAL] We help with the major medical deductible, co-pay and co-insurance up to $2000 for covered outpatient services.
[CUSTOMER][NEUTRAL] We.
[CUSTOMER][NEUTRAL] Uh, can you please hold for a second?
[AGENT][NEUTRAL] Certainly.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Hello [PII]. Hi.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Before, uh, I speak uh with.
[CUSTOMER][NEUTRAL] Uh, [PII] is the representative of, uh, uh, American.
[CUSTOMER][NEUTRAL] Public life and I have a call reference number. He provided me information, it's 100% cover and plan will not cover any uh commercial primary insurance. Uh, can you please recheck information on the?
[AGENT][POSITIVE] I'm so sorry. I am so sorry you spoke with whom?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh, he stated that, uh, plan will cover 100% in uh benefits and the plan will not cover.
[CUSTOMER][NEUTRAL] Uh, any other primary commercial insurance?
[CUSTOMER][NEUTRAL] Only cover medical.
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] Insurance.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] This is a supplemental policy and as far as the outpatient benefits we pay up to $2000 for covered services.
[AGENT][NEUTRAL] As a supplemental, we help with the deductible, co-pay and co-insurance. Would the service be for an office visit or?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Is there a
[CUSTOMER][NEUTRAL] There is no co-pay, no coinsurance, right?
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] With this policy, hello, can you hear me, [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, thank you. With this policy, there's no deductible that has to be met with us, no deductible, co-pay or co-insurance. We help with the major medicals, deductible copay, co-insurance.
[CUSTOMER][NEUTRAL] OK, so it means uh this policy will cover $2000 for outpatient services, right?
[AGENT][NEUTRAL] This policy will cover up to $2000 for all covered outpatient services.
[CUSTOMER][NEUTRAL] Yeah, and uh
[AGENT][NEUTRAL] Is there anything else I can help you with, [PII]?
[CUSTOMER][NEUTRAL] O
[CUSTOMER][NEUTRAL] Uh, just a second.
[CUSTOMER][NEUTRAL] Uh, last time I confirmed, the policy will cover up to $2000 for outpatient services, right?
[AGENT][NEUTRAL] Again, the policy will cover up to $2000 for covered outpatient services.
[CUSTOMER][POSITIVE] Yeah. OK. Uh, thank you so much for giving details. Can you please spell your first name and last name initial?
[AGENT][NEUTRAL] My first name is [PII]. Last initials [PII].
[CUSTOMER][NEUTRAL] And uh what is call reference number?
[AGENT][NEUTRAL] We do not use call reference numbers [PII], however, please use my name and today's date. Anything else I can help you with? Would you need any claim information, submission information?
[CUSTOMER][POSITIVE] No, thank you so much for giving us. Have a nice day. Bye-bye.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you for calling HP. I'll take care bye bye.