AccountId: 011433970860
ContactId: 66ca014d-668b-455c-b08d-954a8531b6af
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 231660 ms
Total Talk Time (AGENT): 68424 ms
Total Talk Time (CUSTOMER): 90934 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/17/66ca014d-668b-455c-b08d-954a8531b6af_20250617T14:52_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. Initial to my last is [PII]. Calling from the facility to check whether, to check the eligibility and the benefits. Could you please help me with that?
[AGENT][POSITIVE] Yes, I can help you with eligibility and benefits more. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, my callback number is [PII] and that's a direct line, no extension.
[AGENT][NEUTRAL] And the policy number for the patient?
[CUSTOMER][NEUTRAL] Sorry, ma'am. Could you please repeat it again?
[AGENT][NEUTRAL] The policy number for the patient?
[CUSTOMER][NEUTRAL] OK. One minute. Uh
[CUSTOMER][NEUTRAL] And the member ID is 949198.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient's first name is [PII] The last name is [PII] and the suffix is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] Yeah, so the policy is active [PII], no term date.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Yeah, are you needing benefits for outpatient services?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] This is not a guarantee of payment, it's the basic outline of the policy.
[AGENT][NEUTRAL] And let me get that pulled up. Give me one moment.
[CUSTOMER][POSITIVE] OK, ma'am. Take your time, no worries.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, for their outpatient benefits, um, they have $2000 per covered person per calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Is it for out of pocket or the
[CUSTOMER][NEUTRAL] Deductible.
[AGENT][NEUTRAL] Um, neither. This is a secondary policy, so this pays up to $2000 after primary processes the claim.
[AGENT][NEUTRAL] pay 100% up to 2000.
[CUSTOMER][NEUTRAL] Hey
[CUSTOMER][NEUTRAL] So there is no individual out of pocket and deductible?
[AGENT][NEUTRAL] No, it's a secondary supplemental gap policy.
[CUSTOMER][NEUTRAL] OK. It is supplementary plan, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So it, it follows the primary guidelines?
[AGENT][NEUTRAL] Right, so whatever's left over from primary, this will pay on the deductible co-insurance or co-pay that's left from primary.
[CUSTOMER][NEUTRAL] One night, ma'am.
[CUSTOMER][NEUTRAL] OK. Then uh then refer also, uh, it, whether it requires.
[CUSTOMER][NEUTRAL] Then the secondary is required. If it doesn't require, then no notice is required, right?
[AGENT][NEUTRAL] There's no author required.
[CUSTOMER][NEUTRAL] And referral
[AGENT][NEUTRAL] Uh, not required.
[CUSTOMER][NEUTRAL] OK. One minute, ma'am. And may I know your last name initially?
[AGENT][NEUTRAL] That's [PII].
[CUSTOMER][NEUTRAL] May I know the call reference number?
[AGENT][NEUTRAL] It's my name [PII], first initial to last name [PII] and today's date.
[CUSTOMER][POSITIVE] Thank you so much for assisting me today. You have a wonderful day and bye for now.
[AGENT][POSITIVE] Thanks for calling APL. You too. Bye-bye.
[CUSTOMER][NEUTRAL] Bye-bye.