AccountId: 011433970860
ContactId: 4d2592eb-3573-4f72-83d4-0c0a1e407e02
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 225190 ms
Total Talk Time (AGENT): 99891 ms
Total Talk Time (CUSTOMER): 99425 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/07/4d2592eb-3573-4f72-83d4-0c0a1e407e02_20250307T20:34_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APO. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi [PII], how are you? This is [PII]. Um, I'm calling in regards to a mutual patient just to get some information in regards to his secondary insurance.
[AGENT][NEUTRAL] Sure [PII], I can assist you with that. Can I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And policy number will be the you want the group number?
[AGENT][NEUTRAL] No, it should say policy or cert number.
[CUSTOMER][NEUTRAL] Uh, let me see secondary.
[CUSTOMER][NEUTRAL] One second charge on the card, all I see insured coverage group number and effective date hospital card number outpatient benefit.
[AGENT][NEUTRAL] Yes, that will be the policy number. It should say cert number.
[CUSTOMER][NEUTRAL] No let me see.
[CUSTOMER][NEUTRAL] Yeah, which one you want the hospital or the outpatient, the outpatient?
[AGENT][NEUTRAL] Either one. It doesn't matter.
[CUSTOMER][NEUTRAL] OK, OK, it's gonna be 01780660, M as in Mary, L 8.
[AGENT][NEUTRAL] Thank you, [PII] and could you verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes ma'am, it's gonna be [PII]. It's supposed to be with a [PII], [PII], and birthday is [PII].
[AGENT][NEUTRAL] And you're calling to verify benefits and eligibility for outpatient services?
[CUSTOMER][NEUTRAL] Outpatient services, yes ma'am.
[AGENT][NEUTRAL] This policy has been active since [PII] and is currently active. The member has a maximum benefit amount of $2500 per calendar year for outpatient services, and this is not a guaranteed benefits, just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] OK, uh, alright, let's go step by step. [PII] of what year?
[AGENT][NEGATIVE] Give me one moment, my system froze up.
[CUSTOMER][NEUTRAL] Hello? Oh sorry.
[CUSTOMER][NEUTRAL] That's OK.
[AGENT][NEUTRAL] [PII] is when the policy became effective and is currently active.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] OK, sounds good.
[CUSTOMER][NEUTRAL] OK. Um, is there any, uh, uh,
[AGENT][NEUTRAL] And the policy is 2500 per calendar year.
[CUSTOMER][NEUTRAL] Yeah, OK, one second, one second, my love, are, uh, co-pays covered?
[AGENT][NEUTRAL] Yes
[AGENT][NEUTRAL] This policy is a, so this is a gap insurance that assists with deductible, co-pay and co-insurance to primary insurance. And those are the benefits for outpatient services, $2500.
[AGENT][NEUTRAL] Per calendar year.
[CUSTOMER][NEUTRAL] He's only covered
[CUSTOMER][NEUTRAL] And how many has he used?
[AGENT][NEUTRAL] He has not utilized any of his benefits for [PII], and this is not a guarantee of benefits, just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so pretty much it's covered up to 2500.
[AGENT][NEUTRAL] Yes, per calendar year.
[CUSTOMER][NEUTRAL] That's what you're saying.
[CUSTOMER][POSITIVE] OK, sounds good thank you so much. I appreciate your time and can I get a rep.
[AGENT][NEUTRAL] Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] No, ma'am. Can I get a reference number to this call?
[AGENT][NEUTRAL] We don't provide those. However, you can use my name and today's date as a reference. It's [PII] and today's date insurance could you provide me the spelling of your name?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Yeah, it's gonna be [PII].
[AGENT][NEUTRAL] Oh, I had that name spelled wrong. Is there anything else that I can assist you with today?
[CUSTOMER][POSITIVE] No, my love, that's it. I appreciate it.
[AGENT][POSITIVE] Thanks for calling APL and have a great day.
[CUSTOMER][POSITIVE] Likewise, thank you.