AccountId: 011433970860
ContactId: 5c7c7591-7ca2-4cd8-8f13-ba57f2ab3d76
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 235279 ms
Total Talk Time (AGENT): 71131 ms
Total Talk Time (CUSTOMER): 107657 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/18/5c7c7591-7ca2-4cd8-8f13-ba57f2ab3d76_20250618T16:31_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], good morning. My name is [PII]. I'm calling with Regency Skin Institute. How are you?
[AGENT][POSITIVE] I'm good. How are you, [PII]?
[CUSTOMER][NEUTRAL] I'm doing all right. Um, we have a patient that is here for an appointment. They're having a procedure done.
[CUSTOMER][NEUTRAL] And um we had given him a quote um we only knew that he had his primary insurance and then as he comes in today he presents a secondary and so I just wanna try to see how you guys will play into effect or yeah yeah pretty much I guess kind of maybe a little bit eligibility information for the patient.
[AGENT][NEUTRAL] OK, what is the policy number? Do we have that?
[CUSTOMER][NEUTRAL] I do. It is 02113810 M Mary L Lima and then the number 7.
[AGENT][NEUTRAL] All right, thank you. And then what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, let's see here, [PII], [PII].
[AGENT][NEUTRAL] All right, thank you. So [PII] is active. It looks like the effective date on here is [PII]. We are the members secondary insurance, so it does cover deductible, co-pay, co-insurance that the primary does not.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] It looks like this member's plan.
[AGENT][NEUTRAL] Let's see what the benefits are here, one second.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, so their outpatient benefit max for the calendar year looks like is a total of $2500.
[CUSTOMER][NEUTRAL] OK, alright, so he's been quoted $500 to pay due to um uh deductible.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And if you guys are picking up and do pick up the deductibles, yeah, 5500 is his deductible.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, but you guys only cover you said how much out of pocket?
[AGENT][NEUTRAL] His outpatient benefit max is 2500 for the calendar year.
[CUSTOMER][NEUTRAL] 2500.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Outpatient Max, so he's having a Mo's procedure done.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I'm trying to figure out if we would be considered this out of pocket.
[CUSTOMER][NEUTRAL] Out of pocket max as long as we're so if we are in network.
[CUSTOMER][NEUTRAL] At most you guys are gonna pick up this 2500 basically correct?
[AGENT][POSITIVE] Yes, ma'am. Uh-huh. Correct, yeah.
[CUSTOMER][POSITIVE] OK. All right. All right, perfect. That is what I needed to verify. What was your name again?
[AGENT][NEUTRAL] My name is [PII] and that's the call reference with today's date. My name is spelled [PII], today's date.
[CUSTOMER][POSITIVE] Perfect. Thank you, [PII]. Have a great day. Bye-bye.
[AGENT][NEUTRAL] You as well bye bye.