AccountId: 011433970860
ContactId: 502f1c70-ba67-47e5-9515-65a325d4f8d9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 125040 ms
Total Talk Time (AGENT): 80995 ms
Total Talk Time (CUSTOMER): 47277 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/502f1c70-ba67-47e5-9515-65a325d4f8d9_20250103T20:09_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Contacting APL, my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] calling from Doctor [PII]'s office. I'm trying to verify benefits and eligibility for a patient that's coming in for the [PII].
[AGENT][NEUTRAL] I can help with benefits and eligibility. [PII], what is that policy number, please?
[CUSTOMER][NEUTRAL] You
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] It's 02538094.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, give me just a moment please. I'm.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh, patient is [PII] uh huh.
[AGENT][NEUTRAL] Yeah, I apologize. Uh, yes, I'm sorry, who's the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII], date of birth [PII].
[AGENT][POSITIVE] I do appreciate that. I'm sorry, I do have to ask for a callback number in the event that we're disconnected.
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Thank you. Uh, [PII], the policy went into effect on [PII]. It is active. Now, for outpatient benefits, what we will do is we will pick up the deductible, co-payment or co-insurance up to $500 per occasion.
[AGENT][NEUTRAL] Um, for outpatient services. Now that's just the verification of the benefits, not a guarantee of payment, and, uh, it renews every 90 days. So $500 per medical event. So if someone sprains their ankle, um, we pay up to $500 for that, and 90 days later they sprang it again it's another $500. They can have multiple events at the same time, uh, and, and it's $500 each. Again, just a verification, not a guarantee of payment.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] Now, the inpatient benefits um for this uh are uh $1500. Uh, again, just a verification, not going to your payment, but there's nothing for office visits or or physicians, just for hospital.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Oh, OK, so this wouldn't pick up like she has Aetna as a primary which she has a deductible and a co-payment you guys don't pick that up then.
[AGENT][NEUTRAL] No, ma'am, we don't. This is strictly for hospitals.
[CUSTOMER][POSITIVE] OK perfect that's all I needed to know, thank you very much.
[AGENT][POSITIVE] OK, thanks for contacting APR have a good day.