AccountId: 011433970860
ContactId: 58d17c21-4356-415f-b2d9-4537563f1bcb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 172440 ms
Total Talk Time (AGENT): 77154 ms
Total Talk Time (CUSTOMER): 60048 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/17/58d17c21-4356-415f-b2d9-4537563f1bcb_20250317T17:24_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from provider office to check the eligibility and benefits for this patient.
[AGENT][NEUTRAL] OK, I can verify benefits and eligibility for you and I apologize, your name is again?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK, thank you. And what is the policy number, please?
[CUSTOMER][NEUTRAL] Yeah, the policy number is
[CUSTOMER][NEUTRAL] 02556241
[AGENT][POSITIVE] OK, thank you so much. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] The callback number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And and to verify the patient's name, date of birth?
[CUSTOMER][NEUTRAL] The patient's name is [PII]. The date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. I've shown her effective date is [PII]. She is active on the policy and what benefits are needing for this patient?
[CUSTOMER][NEUTRAL] Uh, can I know the effective date also?
[AGENT][NEUTRAL] Effective date [PII] and the policy is active.
[CUSTOMER][NEUTRAL] Yeah, uh, for the chemotherapy, have two quotes, uh, whether it will cover the primary deductible.
[AGENT][NEUTRAL] So is this service that's going to be performed in outpatient or in hospital?
[CUSTOMER][NEUTRAL] Outpatient.
[AGENT][NEUTRAL] OK, um, not a guarantee of payment, just a verification of coverage. With this policy as secondary, it helps with primary insurance deductible, co-pay, and or co-insurance, and I show the patient has benefit max of up to $8150 per calendar year.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, um, it will cover 100% of the allowed amount, right up on the, uh, primary.
[AGENT][NEUTRAL] That is their benefit max. So if we pick up what primary applies towards deductible, co-pay or co-insurance up to that benefit max of $8150 per calendar year.
[CUSTOMER][NEUTRAL] Oh sure. After the uh uh deductible, uh, this means the patient has to pay, right?
[AGENT][NEUTRAL] Well, we can give patient responsibility. We can only verify coverage.
[CUSTOMER][POSITIVE] Yeah, sure. Thanks, thank you for assisting me. Have a nice day.
[AGENT][POSITIVE] Oh, you're welcome, too, and thank you for calling APL. Have a great day.
[CUSTOMER][POSITIVE] Yeah, thank you, enjoy.
[AGENT][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Another one
[CUSTOMER][NEUTRAL] What.