AccountId: 011433970860
ContactId: 4d812343-1649-4a83-ab22-dcfd9580b9de
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 163919 ms
Total Talk Time (AGENT): 73576 ms
Total Talk Time (CUSTOMER): 73719 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/4d812343-1649-4a83-ab22-dcfd9580b9de_20250128T13:24_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, I was calling to see if I could get eligibility and benefits on a client and it would be for outpatient mental health excuse me.
[AGENT][NEUTRAL] OK, what's the chief complaint?
[CUSTOMER][NEUTRAL] Oh, let me look and see if I can find out what his diagnosis is.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. His diagnosis is schizophrenic.
[AGENT][NEUTRAL] OK. And your name?
[CUSTOMER][NEUTRAL] [PII]?
[AGENT][NEUTRAL] [PII], what's the policy number?
[CUSTOMER][NEUTRAL] 02486372
[AGENT][NEUTRAL] And I'll get phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you for that, [PII]. One moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And are you guys a supplement to Medicare or you are primary insurance?
[AGENT][NEUTRAL] Um, let me pull up the policy and I can verify.
[CUSTOMER][NEUTRAL] OK, all right.
[AGENT][NEUTRAL] What's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] date of birth [PII].
[AGENT][NEUTRAL] OK, so this is a limited hospital indemnity policy. Um, I don't know whether the patient has other coverage or not. That's a question for the patient.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so this is just hospital only.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Well, that's the type of policy it is, but it has other benefits other than just inpatient.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And so you said that this is for service, is it in an office setting?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So this policy has an in-hospital benefit. Um, there is a
[AGENT][NEUTRAL] Surgical benefit if there's a surgery in a facility setting or office setting, and then there's a diagnostic testing benefit. So there's not a primary care.
[CUSTOMER][NEUTRAL] There's no mental, OK.
[AGENT][NEUTRAL] Yeah, benefit under this particular policy.
[CUSTOMER][NEUTRAL] OK, but would you guys have been a supplement because we're having a hard time finding out like we've got a Medicare number for him, but when we checked the Medicare website like nothing comes up.
[CUSTOMER][NEUTRAL] So I wouldn't think you're, can you tell if you'd be a supplement or if you would be his primary?
[AGENT][NEUTRAL] We, I, I don't know if it seem like Medicare would be prime if he, if she, if she or he.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is it a she? Uh huh oh.
[AGENT][NEUTRAL] Um, let me see. It's a male. If he has Medicare, that would be a question for Medicare.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, all right, thank you so much.
[AGENT][NEUTRAL] All right. Any other questions, [PII], I can help out with today?
[CUSTOMER][NEUTRAL] That's it.
[AGENT][POSITIVE] All right, thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][NEUTRAL] Bye-bye.