AccountId: 011433970860
ContactId: 496911ae-097a-4cfa-bc6e-19f4edbcfa1a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 339339 ms
Total Talk Time (AGENT): 101029 ms
Total Talk Time (CUSTOMER): 147686 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/20/496911ae-097a-4cfa-bc6e-19f4edbcfa1a_20250520T13:59_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][POSITIVE] A very pleasant good morning [PII]. How are you?
[AGENT][POSITIVE] I'm doing good. How are you?
[CUSTOMER][POSITIVE] Alright, I'm doing great, thank you for asking. My name is [PII] calling from Jackson Memorial Hospital. I'm verifying a member, um.
[CUSTOMER][NEUTRAL] Secondary gap insurance and to see if it takes care of her deductible co-insurance and copay.
[AGENT][NEUTRAL] OK. Did you say your name was [PII]?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK. And do you have a phone number I can get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] My direct number is [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, ma'am. The policy number is 02364219 M as in Mary, L as in Lima 7.
[AGENT][NEUTRAL] Thank you, [PII]. Hold on one moment, please.
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] Yet, [PII]
[AGENT][NEUTRAL] OK, I must have the wrong policy number. What's that policy number again?
[CUSTOMER][NEUTRAL] 02362419 M as in Mary, L as in Lima number 7.
[AGENT][NEUTRAL] OK, I have it now. Sorry about that. And what's her date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII] and you want to know if this policy, uh, picks up the deductible copay or co-insurance?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, I can help you with that. Hold on one moment.
[AGENT][NEUTRAL] OK, the policy number you gave me canceled 4124. She does have another policy.
[AGENT][NEUTRAL] And that policy number is 02.
[AGENT][NEUTRAL] 493-426
[CUSTOMER][NEUTRAL] You said 02493426?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] And the effective date is [PII].
[AGENT][NEUTRAL] Any benefits given over the phone is not a guarantee of payment.
[AGENT][NEUTRAL] This policy does coordinate with the primary insurance.
[CUSTOMER][NEUTRAL] Or
[AGENT][NEUTRAL] We pick up deductible, co-pay or co-insurance only depending on what the services is. Is it for outpatient, inpatient or doctor's office?
[CUSTOMER][NEUTRAL] It's outpatient for follow up visit along with a breast ultrasound.
[AGENT][NEUTRAL] So it's for outpatient?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, for outpatient we'll pay up to 750 per calendar day.
[CUSTOMER][NEUTRAL] And it doesn't matter what service it is or it does?
[AGENT][NEUTRAL] If it's outpatient, it'll, it'll pay up to that 750.
[CUSTOMER][NEUTRAL] OK, so with her co-pay that she has with her insurance, she's responsible for 250, so as long as it doesn't go over that then you guys.
[CUSTOMER][NEUTRAL] That's where the seconder comes in.
[AGENT][NEUTRAL] Right.
[CUSTOMER][POSITIVE] OK, so the policy number you said 02493426, it's so funny that this patient.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Was, let's see, she was supposed to be here on the [PII], and I do remember called in.
[CUSTOMER][NEGATIVE] And the rep that I spoke to did not give me this information.
[CUSTOMER][NEUTRAL] As far as telling me that the policy number that was, I don't know.
[CUSTOMER][NEUTRAL] But it is what it is.
[CUSTOMER][NEUTRAL] OK, patient number.
[CUSTOMER][NEUTRAL] Alright, so cover 750 per calendar date.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alrighty, thank you so very much, Ms. [PII], initial of your last name and a reference number.
[AGENT][NEUTRAL] We do not have reference numbers you can use my name in today's date.
[CUSTOMER][NEUTRAL] Initial of your last name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Is there anything else I can help you with?
[CUSTOMER][POSITIVE] No, ma'am. Enjoy the rest of your day and do have yourself a blessed and peaceful remaining of the week.
[AGENT][POSITIVE] Thank you, [PII], for calling APLU as well.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Thank you bye bye thank you.
[AGENT][NEUTRAL] Mm bye-bye.