AccountId: 011433970860
ContactId: 56ed21d8-1edc-4803-ae8c-7bb2d15d8459
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 274190 ms
Total Talk Time (AGENT): 95885 ms
Total Talk Time (CUSTOMER): 124274 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/56ed21d8-1edc-4803-ae8c-7bb2d15d8459_20250415T20:57_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, um, I was calling to verify a patient's insurance, um, at the secondary. She's getting chemotherapy here at this hospital. And she just bought in her, her, this card for us to add as her secondary insurance.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, well I can definitely help you with the eligibility and may I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Um, the, my name is [PII], and the best contact number is [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Um, the policy number is 017494.
[CUSTOMER][NEUTRAL] 78
[CUSTOMER][NEUTRAL] M as in Mary, L 8.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Uh, it is [PII], [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment, and I am showing the policy is active. It's been effective since [PII].
[CUSTOMER][NEUTRAL] [PII], OK.
[CUSTOMER][NEUTRAL] [PII]. Is there any um deductibles or co-insurance or anything the patient's responsible for?
[AGENT][NEUTRAL] So for this
[AGENT][NEUTRAL] Um, for the secondary insurance, no, we help pay the deductible, co-pay and co-insurance if primary charges.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, so this covers like 20% of, of like, um, cause I think, let me see her, yeah, her primary is Blue Cross Blue Shield. They cover, let's see.
[CUSTOMER][NEUTRAL] OK. Um.
[CUSTOMER][NEUTRAL] The only thing that looks like she will be, yeah, the deductible. She has like a $1000 deductible for Blue Cross Blue Shield and out of pocket. So you would cover, help cover the deductible, you said?
[AGENT][NEUTRAL] Right, so we pay towards the copay, deductible and co-insurance of covered charges after primary. Are you all considered outpatient or inpatient?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Outpatient.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] So for outpatient, the policy will pay up to $1000 per calendar year.
[AGENT][NEUTRAL] Um, did you want me to see if she's used any of that, uh, for the year?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] Yes, please. Yes, please. I appreciate that.
[AGENT][NEUTRAL] OK, hold on one moment. You're welcome.
[CUSTOMER][NEUTRAL] Yeah because it looks like she has a $1000 deductible so if you guys pay towards the.
[AGENT][NEUTRAL] So she has
[CUSTOMER][NEUTRAL] The co-pay deductible.
[AGENT][POSITIVE] Oops, I'm sorry.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I can hear you now.
[AGENT][NEUTRAL] Um, she has 900 left for the year. She's used 100 for 2025.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. And
[AGENT][NEUTRAL] Now keep in mind it is we process the claims as they come in, so that's for the full year. So other claims come in in between now and when you
[CUSTOMER][NEUTRAL] That might take away from them, you know, when the bills or something. OK. Um, all right. So, yeah, cause it looks like she has a co-pay of like $350 for like chemo. So hopefully that, that goes through once it, uh, uh, the bill is sent in. Is there a reference number or a
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date and again that's [PII] The first initial of my last name is [PII].
[CUSTOMER][NEUTRAL] For the call.
[CUSTOMER][POSITIVE] OK. Thank you so much, [PII]. Appreciate you.
[AGENT][POSITIVE] You're very welcome, [PII]. Was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] Um, no, that'll be it. Thank you.
[AGENT][POSITIVE] Alright, thanks for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] You too. Thank you. Bye-bye.
[AGENT][NEUTRAL] Bye bye.