AccountId: 011433970860
ContactId: 4c83ed07-8bbd-46ad-a665-7cde0b9984bc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 170419 ms
Total Talk Time (AGENT): 72119 ms
Total Talk Time (CUSTOMER): 122448 ms
Interruptions: 6
Overall Sentiment: AGENT=0.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/06/4c83ed07-8bbd-46ad-a665-7cde0b9984bc_20250606T20:44_UTC.wav
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[CUSTOMER][NEUTRAL] Hi [PII], good afternoon. My name is [PII] and I'm calling for Texas Digestive Specialist. I'm calling because I want to know for um some CPT codes for a member. I don't know if you can able to help me with that.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Uh, let's take a look, [PII]. Do you have their policy number?
[CUSTOMER][NEUTRAL] Yes, yes, I have 01868788.
[AGENT][NEUTRAL] What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you. So the patient is active. The effective date on here is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, this, this is a secondary insurance. So this picks up their deductible, co-pay, co-insurance that their primary does not.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Oh OK perfect.
[CUSTOMER][NEUTRAL] And then for for this um insurance, the patient has advises uh the insurance cover procedures uh 2500 something like that. I don't know that's why the reason I call.
[AGENT][NEUTRAL] Are they gonna be seen on an outpatient basis?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so their outpatient uh benefit amount for the calendar year is 2550, so that's their benefit max for the year.
[CUSTOMER][NEUTRAL] of the year.
[CUSTOMER][NEUTRAL] We don't need to no.
[CUSTOMER][NEUTRAL] Although that you've completed your deductible OK.
[AGENT][NEUTRAL] And let me see what they've used.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Do you know that.
[AGENT][NEUTRAL] It doesn't look like they've used anything to date so for their outpatient they have the full 2550 available.
[CUSTOMER][NEUTRAL] They don't ask when they pay at the, but the decision on when they.
[CUSTOMER][NEUTRAL] OK, but you enter after the primary, right? If the primary doesn't cover certain amount, you, you cover for that, OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right, we pick up their deductible, co-pay or co-insurance from the primary.
[CUSTOMER][POSITIVE] OK, OK, perfect. OK, thank you so much. uh, can you please give me a reference number for this call or?
[AGENT][NEUTRAL] Yeah, absolutely. Call reference is my name with today's date. My name again is [PII], that's [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then my last initial is gonna be [PII].
[CUSTOMER][NEUTRAL] yes.
[CUSTOMER][POSITIVE] Perfect thank you so much for your help. Have a good one you too bye bye.
[AGENT][POSITIVE] You're welcome have a good day.
[AGENT][NEUTRAL] You too.