AccountId: 011433970860
ContactId: 492f0f70-50ee-4598-ae72-899a24a0b489
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 155979 ms
Total Talk Time (AGENT): 91360 ms
Total Talk Time (CUSTOMER): 49476 ms
Interruptions: 2
Overall Sentiment: AGENT=1.5, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/04/492f0f70-50ee-4598-ae72-899a24a0b489_20250604T20:10_UTC.wav
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[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Hello, my name is [PII]. I'm calling on behalf of North Oaks Medical Center, and I'm trying to verify coverage on a patient, please.
[AGENT][NEUTRAL] I can certainly have a benefit, [PII]. What is that policy number?
[CUSTOMER][NEUTRAL] Uh, yes, ma'am. The policy number is 1265691.
[CUSTOMER][NEUTRAL] For Mr. [PII].
[CUSTOMER][NEUTRAL] His date of birth is [PII].
[AGENT][POSITIVE] I do appreciate that. Thank you. And if I could just have a callback number please.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Yes ma'am, it's [PII] and it's a direct line.
[AGENT][NEUTRAL] Thank you. The policy went into effect on [PII]. It is active.
[AGENT][NEUTRAL] Now, this is a secondary or gap insurance which has benefits for in and out of hospital, um.
[AGENT][NEUTRAL] Treatment within the physician's office, cancer treatment in the labs.
[AGENT][NEUTRAL] Are we looking for the independent or excuse me, the uh inpatient benefits or the outpatient?
[CUSTOMER][NEUTRAL] Uh, the patient came in for an ENT visit, so it's a doctor's office. It's uh uh outpatient.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, great. So what we will do is we will pick up the deductible, co-payment or co-insurance for that type of visit up to $4750 per calendar year. That is just a verification it's not a guarantee of payment. Now, [PII], there is a, uh, $250 deductible that must be met first for this policy. So these policies also have a deductible.
[AGENT][NEUTRAL] And in this case, it's $250 per calendar.
[AGENT][NEUTRAL] Not met that yet, so that would have to be met before the policy paid out but it, it, it does cover um services within the.
[AGENT][NEUTRAL] Would you like to know where to send your claim or is there anything else that I can tell you about it?
[CUSTOMER][NEUTRAL] OK, yes ma'am.
[CUSTOMER][NEUTRAL] When when did you say the date of this policy was?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] What and what was your name ma'am?
[AGENT][POSITIVE] My name is also [PII]. We're gonna use my initial, uh, which is [PII]. It is, yeah, thank you very much.
[CUSTOMER][NEUTRAL] Your name [PII] too?
[CUSTOMER][POSITIVE] Well I hope you have a good day, Miss [PII].
[AGENT][NEUTRAL] Well, remember this, right? and uh so yeah, so.
[CUSTOMER][NEUTRAL] You got it and do you have a reference number for our call?
[AGENT][NEUTRAL] It's, it's just gonna be my name and today's date.
[CUSTOMER][NEUTRAL] Oh well then I, I'll remember that.
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] Well thank you very much for contacting us.
[CUSTOMER][POSITIVE] Thank you so much, ma'am. I appreciate your time.
[AGENT][POSITIVE] You have a very good day. Thank you for calling.