AccountId: 011433970860
ContactId: 5852271e-c54e-4c61-95b5-1c041a9acecf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 239179 ms
Total Talk Time (AGENT): 84815 ms
Total Talk Time (CUSTOMER): 127355 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/12/5852271e-c54e-4c61-95b5-1c041a9acecf_20250212T17:34_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, um, my name is [PII] and I am calling from a provider's office, and I just wanted to check, um, we have a patient coming in to see us and he provided us with this APL as his secondary so I was just calling to make sure it is active, um, as his secondary and then I was wondering if you're able to tell me if it covers copays or um some other codes that I have or some other benefits.
[AGENT][NEUTRAL] OK, uh, [PII], what is that policy number, please?
[CUSTOMER][NEUTRAL] Um, do you want the outpatient benefit certificate number?
[AGENT][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] OK. 02369687, M as in Mike, L as in Lima, 8.
[AGENT][POSITIVE] OK, thank you so much. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] OK, and verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] [PII], um, [PII].
[AGENT][NEUTRAL] OK, I'm showing that policy number you gave it terminated on [PII]. So when you're ready, I can give you the current policy number.
[CUSTOMER][NEUTRAL] Oh, OK, I will take that. Go ahead.
[AGENT][NEUTRAL] OK, it's 251-813-9.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the effective date is [PII]. Policy is active. And you say you're needing outpatient benefits, is that correct?
[CUSTOMER][NEUTRAL] Yeah, so we're a pain management clinic, um, and he's coming in for a uh pain management injection.
[CUSTOMER][NEUTRAL] Um, and the patient thought that the secondary would cover, um, like the deductible because he's subject to his deductible for injections with his primary insurance.
[AGENT][NEUTRAL] OK, well, with this policy as secondary, we do help with major medicals, deductible, co-pay or co-insurance, um, not a guarantee of payment, just a verification of coverage for outpatient. The max payable is up to 2000.
[AGENT][NEUTRAL] That's funny, $2,025 per calendar year.
[CUSTOMER][NEUTRAL] OK, has he met any of that this year, do you know?
[AGENT][NEUTRAL] Uh, give me a moment.
[AGENT][NEUTRAL] Uh, no, ma'am, he hasn't, so it is available.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So we would just bill the primary and then bill you a secondary then correct?
[AGENT][NEUTRAL] Uh yes, ma'am.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] And then are you able to verify the claims address for me?
[AGENT][NEUTRAL] Sure, it's [PII], um, not, I'm sorry about your old address [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Perfect. OK, and then I just wanna verify that new um ID number was 251-8139.
[AGENT][POSITIVE] Uh, that is correct. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, so no no letters in this one it's just the numbers this time.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] OK, I think that's everything I needed. Do you give call reference numbers?
[AGENT][NEUTRAL] Uh, no, ma'am, we don't. If you like, you may use my name in today's date.
[CUSTOMER][POSITIVE] OK perfect all right thank you very much I appreciate your help.
[AGENT][POSITIVE] Alright, you're welcome. Uh thank you for calling APL. Have a great day, [PII].
[CUSTOMER][POSITIVE] You too thank you bye bye.
[AGENT][NEUTRAL] Mhm, bye.