AccountId: 011433970860
ContactId: 65b4ea72-d01f-4d10-951b-27ce6e7583ea
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 379500 ms
Total Talk Time (AGENT): 118500 ms
Total Talk Time (CUSTOMER): 133049 ms
Interruptions: 1
Overall Sentiment: AGENT=0, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/10/65b4ea72-d01f-4d10-951b-27ce6e7583ea_20250210T14:10_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm calling from the provider office looking for the benefit for this member I would like to assist me today.
[CUSTOMER][NEUTRAL] So yeah
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] And the policy number only?
[CUSTOMER][NEUTRAL] Yeah, the policy number is gonna be.
[CUSTOMER][NEUTRAL] Mm just a moment.
[CUSTOMER][NEUTRAL] 02448913
[CUSTOMER][NEUTRAL] M L
[AGENT][NEUTRAL] And what's to get
[AGENT][NEUTRAL] A good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, it's gonna be [PII] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, you fade out. You gave me [PII]. What is the extension?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Yeah, that's correct.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And you said that you're checking benefits?
[CUSTOMER][POSITIVE] Yes yes
[AGENT][NEUTRAL] And is this for service in a doctor's office?
[CUSTOMER][NEUTRAL] Yeah, I'm calling from this facility.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Calling, I'm calling from the facility.
[AGENT][NEUTRAL] OK, so it's outpatient, and what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah, the patient's name is gonna be [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that information, Ali. The policy effective date is [PII]. Uh, this policy is active at this time.
[AGENT][NEUTRAL] And I show the maximum outpatient benefit is up to $500 per calendar day.
[AGENT][NEUTRAL] The information provided is verification, not a guarantee of payment, and did you have any other questions?
[CUSTOMER][NEUTRAL] Yeah, I want to check that.
[CUSTOMER][NEUTRAL] The as a secondary first of all, you confirm that the 2nd day of this number.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Are the secondary or the primary?
[AGENT][NEUTRAL] Secondary.
[CUSTOMER][NEUTRAL] So, as a secondary, you will cover the coinsurance and deductible for the primary BCBS.
[AGENT][NEUTRAL] Of covered charges, yes.
[CUSTOMER][NEUTRAL] You will cover
[CUSTOMER][NEUTRAL] Also the deductible, also deductible, is that right?
[AGENT][NEUTRAL] Yes, of covered charges.
[CUSTOMER][NEUTRAL] Is there any secondary deductible pending or not?
[AGENT][NEUTRAL] Not under this policy, sir. The benefit is $500 per calendar day and that's it.
[CUSTOMER][NEUTRAL] Uh,
[AGENT][NEUTRAL] Any other questions?
[CUSTOMER][NEUTRAL] You said this $500.
[AGENT][NEUTRAL] Per calendar day.
[CUSTOMER][NEUTRAL] Per calendar year.
[AGENT][NEUTRAL] It's per calendar day.
[CUSTOMER][NEUTRAL] Park calendar.
[CUSTOMER][NEUTRAL] So there is the 5000 deductible 500 deductible, so you will cover for the primary BCBS, is that right?
[AGENT][NEUTRAL] It's not a deductible, that's the benefit. The benefit is 5 up to $500 per calendar day.
[CUSTOMER][NEUTRAL] Yeah, but you will cover, uh, I, I want to confirm that you will cover the deductible and the co-insurance for the primary CBS.
[AGENT][NEUTRAL] OK, we can't guarantee a benefit until we receive the claim, so information provided is verification only it doesn't guarantee payment of a claim.
[CUSTOMER][NEUTRAL] Yes, I want to confirm that.
[AGENT][NEUTRAL] And the benefit is up to $500 per calendar day.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] So you will cover the
[CUSTOMER][NEUTRAL] Per calendar year up to 500, is that right?
[AGENT][NEGATIVE] [PII], can I speak with your supervisor please? Because I don't think we're understanding each other.
[AGENT][NEUTRAL] And I can explain the benefit to the supervisor if you don't mind.
[CUSTOMER][NEGATIVE] No, no.
[CUSTOMER][NEUTRAL] Uh, uh, just, I want to confirm that.
[CUSTOMER][NEUTRAL] So you, you will cover the deductible and the co-insurance for the primary BCBS if the primary lefty lefty.
[AGENT][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] OK, can I speak with your supervisor please, [PII]?
[CUSTOMER][NEUTRAL] Co-insurance and deductible, you will be covered.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] So the benefit is up to $500 per calendar day of covered charges.
[CUSTOMER][NEGATIVE] There is no available.
[CUSTOMER][POSITIVE] OK, thank you so much for that information.
[AGENT][NEUTRAL] Anything else?
[CUSTOMER][POSITIVE] I'm ready for the call first.
[AGENT][NEUTRAL] My name and today's date.
[CUSTOMER][NEUTRAL] Your name?
[AGENT][NEUTRAL] [PII], first initial last name is [PII].
[CUSTOMER][NEUTRAL] And today's date, is it right?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] And the today's date.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, thank you so much for the information. Thanks a lot. Have a wonderful day.
[AGENT][POSITIVE] You're welcome thanks for calling APL have a good day.
[CUSTOMER][NEUTRAL] Mhm bye bye.