AccountId: 011433970860
ContactId: 4c04a0e6-a18c-4bcc-8fe2-b6415a7c8459
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 360920 ms
Total Talk Time (AGENT): 135510 ms
Total Talk Time (CUSTOMER): 141174 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/4c04a0e6-a18c-4bcc-8fe2-b6415a7c8459_20250321T12:27_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. I'm calling on behalf of a patient that's having a procedure in our facility. I need to verify, uh, if the plan if this is a secondary plan and if the plan is active and if it covers.
[CUSTOMER][NEUTRAL] Copay.
[AGENT][NEUTRAL] OK, just me.
[AGENT][NEUTRAL] I can get that for you. Um, do you have that policy number?
[CUSTOMER][NEUTRAL] Yes, policy number is um.
[CUSTOMER][NEUTRAL] Where is the policy?
[CUSTOMER][NEUTRAL] It says payer ID maybe is that the policy number?
[AGENT][NEUTRAL] Um, I can try that.
[CUSTOMER][NEUTRAL] 608.
[CUSTOMER][NEUTRAL] 01 group number 25886.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what is your name, ma'am?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and do you mind if I get a callback number from you?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][POSITIVE] OK, thank you, Ms. [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what is the um patient's name?
[CUSTOMER][NEUTRAL] Patient name is um.
[CUSTOMER][NEUTRAL] Uh, [PII] last name I'm gonna spell it for you.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] You need date of birth?
[AGENT][NEUTRAL] OK. Yes, ma'am, please.
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you. That is what we show. Um
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now the policy um shows it was effective [PII].
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Effec effective date is when?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], no term date?
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] There's no term date?
[AGENT][NEUTRAL] No, ma'am. No, ma'am.
[CUSTOMER][NEUTRAL] OK, and um it does cover the deductible, the primary uh co-pay deductible?
[AGENT][NEUTRAL] OK, um, I'm gonna transfer you over to our claims department for that we do cover, um, you know, co-pays and deductibles, but they can let you know the exact amount.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I'm sorry, are you gonna, can you tell me how much they have available like um in the plan?
[AGENT][NEUTRAL] Um, now I can transfer you to our benefits and claims department and they can let you know that.
[CUSTOMER][POSITIVE] OK perfect
[AGENT][NEUTRAL] OK, I'm sorry, but I do need to transfer you for that part.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, thanks, can you get me a live representative please?
[AGENT][NEUTRAL] OK. Yes, ma'am.
[AGENT][POSITIVE] Oh, yes, ma'am, absolutely.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, but is there anything else I can do for you before I transfer you?
[CUSTOMER][NEUTRAL] No, what's the policy number? Does the with the payer ID, that's the policy number?
[AGENT][NEUTRAL] Oh, yes. Um, now the policy number is 231-731-0.
[CUSTOMER][NEUTRAL] like
[CUSTOMER][NEUTRAL] 231-731-0.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK, 231-731-0 perfect. OK, can I get them a representative, please? Thank you so much.
[AGENT][POSITIVE] OK, yes ma'am, and you have a good day and thank you for calling APL.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Referring.
[CUSTOMER][NEUTRAL] Referring.
[CUSTOMER][POSITIVE] Thank you for contacting APL. My name is [PII]. How may I help you?
[AGENT][NEUTRAL] Hey, this is [PII]. I have a provider's office on the line and they need to check um.
[AGENT][NEUTRAL] Benefits for an insured. I'm so sorry I went blank. They need to check the benefits she was asking like the deductible what we would pay that kind of thing on a midlink policy, um, but the policy number is 231-731-0.
[CUSTOMER][NEUTRAL] Sure, of course.
[CUSTOMER][POSITIVE] Thank you and who's on the phone?
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Her name is [PII]. She spelled it [PII].
[CUSTOMER][POSITIVE] Great, I, I can certainly help her.
[AGENT][NEUTRAL] OK, I do have her callback number [PII].
[CUSTOMER][POSITIVE] OK, thank you. [PII], I, I can take it from here. Thanks.
[AGENT][NEUTRAL] OK. And I did verify the birthday of the insured, but that was all. Um, so, OK.
[CUSTOMER][POSITIVE] Yeah, thank you, that's great.
[AGENT][POSITIVE] All right, here she comes. Thank you.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] You didn't I thank you for contacting APL. My name is. I'm in the claims department. I understand that you wanted to know about the benefits for a [PII], uh, yes, so first of all, this policy went into effect on [PII].
[CUSTOMER][NEUTRAL] It is active. Now this is a secondary or gap insurance, and what we do is we take, we pick up the deductible co-payment or co-insurance from his major medical for inpatient, outpatient services, treatment within a physician's office. Is there anything?