AccountId: 011433970860
ContactId: 50805060-75f1-4a47-8e93-767954695559
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 198179 ms
Total Talk Time (AGENT): 103505 ms
Total Talk Time (CUSTOMER): 35594 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/50805060-75f1-4a47-8e93-767954695559_20250509T15:45_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Can you verify benefits on a patient?
[AGENT][POSITIVE] OK, sure. I can assist you with benefits. And may I have your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. And Miss [PII], may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And may I have the name of the facility you're calling from, Miss [PII]?
[CUSTOMER][NEUTRAL] Northeastern Health System.
[AGENT][NEUTRAL] OK. Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] 02579335
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Mm, thank you, Mrs. He and you say you need eligibility today, correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. We have an effective date of [PII]. It is active at the moment, and this is one of our secondary supplemental plan to the major medical.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you need any other information, Ms. [PII]?
[CUSTOMER][NEUTRAL] Um, is there a deductible or out of pocket expense copays?
[AGENT][NEUTRAL] Uh, this is a secondary policy to the major medical. So what we do is we help with the co-payments, co-insurance and deductibles from the major medical based on the place of service and the service rendered. Um, what type of service is being rendered, Miss [PII]?
[CUSTOMER][NEUTRAL] Um, radiology, they're having an ultrasound.
[AGENT][NEUTRAL] OK. Outpatient.
[AGENT][NEUTRAL] Facility? Oh, OK. Yes. Um, so this is not a guarantee of payment, just the verification of coverage and that's just a disclaimer. We have an outpatient maximum of 3500 per covered person per calendar year. And again, this is to help with the deductibles, co-payments, and co-insurance from the major medical.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And have they used any of that?
[AGENT][NEUTRAL] I can check for you. Let's see.
[AGENT][NEUTRAL] OK. So as of today, he has only used $30.
[CUSTOMER][NEUTRAL] OK, and what did you say your name was?
[AGENT][NEUTRAL] My name is [PII] [PII].
[CUSTOMER][NEUTRAL] Is there a reference number for speaking with you?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you would like.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. You have a good day.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] You're family.