AccountId: 011433970860
ContactId: 53201a83-ed5d-4c77-b86c-2213169bdbd2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 224270 ms
Total Talk Time (AGENT): 114631 ms
Total Talk Time (CUSTOMER): 109691 ms
Interruptions: 2
Overall Sentiment: AGENT=0.7, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/53201a83-ed5d-4c77-b86c-2213169bdbd2_20250221T13:26_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Hi, yes, uh, good morning. You said [PII] is your name, right? [PII]?
[AGENT][NEUTRAL] [PII], yes, sir.
[CUSTOMER][NEUTRAL] Uh, my, my name is [PII] can you spell your name? I, I need to ask you, uh, eligibility. That's the reason my call.
[AGENT][NEUTRAL] OK, I can spell my name. It's [PII].
[CUSTOMER][NEUTRAL] OK, OK, OK, so, uh, alright, the question is about this patient. She needs to receive service, but she present this like a coverage with you guys. I want, I need to confirm the, the coverage.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, give me that policy number.
[CUSTOMER][NEUTRAL] Yes, I have 02565807.
[AGENT][NEGATIVE] Uh, say that one more time. My, my phone was bleeping out.
[CUSTOMER][NEUTRAL] Yeah, yeah, no problem, it's 02002, then 56.
[CUSTOMER][NEUTRAL] And 58.
[CUSTOMER][NEUTRAL] 07.
[AGENT][NEUTRAL] Alright, [PII], thank you for that information. Now, while I am keying this in, go ahead and give me a good return telephone call number.
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] All right, [PII], thank you for that information. What's your patient's name and date of birth today, please, sir?
[CUSTOMER][POSITIVE] Alright thank you.
[CUSTOMER][NEUTRAL] Yes, the, the, the name is uh [PII].
[CUSTOMER][NEUTRAL] And uh last name is [PII]
[AGENT][NEUTRAL] Alrighty, [PII], thank you for all that information. Looks like [PII] is the insured on this medical supplemental plan. Do show her original effective date is [PII]. She is still current and active, but I must advise that verification of coverage is not a guarantee of payment on the claim. But you did say you want to see eligibility, is that correct?
[CUSTOMER][NEUTRAL] Yeah, and, uh, well I need to know how much is she covered. She, she, she will be in a, in a procedure. It's not too much, but we need to know if it will be covered, uh, that whatever is is missing, uh, that the, the prime insurance is not covering.
[AGENT][NEUTRAL] OK, what is she having done and where is she having it done at?
[CUSTOMER][NEUTRAL] Uh, it's a surgery and she is in the Palmetto General Hospital. That's the place, and she's, I don't know what she's doing exactly.
[CUSTOMER][NEUTRAL] I don't have the name of the procedure. Uh, yeah, it's, it's a medical.
[AGENT][NEUTRAL] Is, is it gonna be inpatient or out?
[CUSTOMER][NEUTRAL] Uh, out, outpatient.
[AGENT][NEUTRAL] Outpatient, OK. All right, and of course what we are is her medical supplemental plan. So the only thing that we will pick up and pay on is anything that is applied towards her deductible, co-pay, or co-insurance for sickness and injury at her primary insurance carrier. Nothing routine here is covered no matter what, but her outpatient benefit here is gonna be a zero deductible.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And she has 8500 outpatient benefit here.
[CUSTOMER][NEUTRAL] You said 500?
[AGENT][NEUTRAL] 8500.
[CUSTOMER][POSITIVE] Oh, OK, 8500 perfect. OK, got it, alright.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, sir. And is that all that I can help you with?
[CUSTOMER][NEUTRAL] Alright, no, that's it. I, I, I, I, I, um, if you give me a referral number for this call.
[AGENT][NEUTRAL] We do not give reference numbers, but you can use my name in today's date, [PII], OK?
[CUSTOMER][NEUTRAL] OK, what's the, the initial of your last name please?
[AGENT][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] It's an [PII], right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] Alright, alright, I got it. OK, perfect. Thank you very much.
[AGENT][POSITIVE] Well, yes, sir, [PII], thanks for calling APL. Have a great Friday. Bye-bye.
[CUSTOMER][POSITIVE] Mhm you too you too thank you very much.
[AGENT][NEUTRAL] Mhm, you too.