AccountId: 011433970860
ContactId: 6d9f424b-e932-444a-8612-932c60f59737
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 286010 ms
Total Talk Time (AGENT): 97581 ms
Total Talk Time (CUSTOMER): 145808 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/6d9f424b-e932-444a-8612-932c60f59737_20250207T21:28_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII], and I'm calling on a recorded line for quality and training purposes to request benefits for Orzodex, which has been requested by Doctor [PII]. And how we are doing today, [PII]?
[AGENT][POSITIVE] I'm doing well, um, [PII], how are you?
[CUSTOMER][POSITIVE] I'm doing good as well, [PII]. Thank you for asking.
[AGENT][NEUTRAL] You're welcome, and may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, sure. The contact number is [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yeah, the policy number is 1,006,470.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] To.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] the
[CUSTOMER][NEUTRAL] Sure
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, sure, [PII]. The name is
[CUSTOMER][NEUTRAL] [PII]. And the date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So I am showing that the policy is no longer active. It was effective from [PII].
[CUSTOMER][NEUTRAL] Uh just um.
[CUSTOMER][NEUTRAL] Uh, and, uh, was this a Medicare Advantage plan previously?
[AGENT][NEUTRAL] No, um, this is their Medi Medicare, sorry, this is their Medlink supplemental gap insurance, so it's a supplemental policy, and it was second only to, hold on, let me see who they're second to.
[CUSTOMER][NEUTRAL] I don't know.
[CUSTOMER][NEUTRAL] Hi.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] This is
[CUSTOMER][NEUTRAL] It's.
[AGENT][NEUTRAL] I'm sorry, this is a hospital indemnity policy. Hold on one moment, let me go back. This is a hospital indemnity policy, so it's a limited medical benefit um policy?
[AGENT][NEUTRAL] This is not in relation to Medicare and Medicaid.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, got it, [PII]. Thank you for that. And what type of plan was this like uh PPO, HMO, EPO?
[AGENT][NEUTRAL] Hospital, hospital indemnity. There's no network, it's a limited medical benefit policy.
[CUSTOMER][NEUTRAL] OK. Got it, [PII]. Thank you for that. Uh, [PII], just to confirm the policy and it was [PII] for the member?
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][NEUTRAL] Oh, can you say that one more time?
[CUSTOMER][NEUTRAL] Yeah, just to confirm the policy and date, was it [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII], yes, is when it turned.
[CUSTOMER][NEUTRAL] OK. Got it, [PII]. Thank you for that. Uh, and I think I'm good to go with this member. I just like to reconfirm the information provided. So this is an indemnity plan and uh the name of the policy is APL Hospital indemnity. Effective dates were [PII], uh, and, uh.
[CUSTOMER][NEUTRAL] The termination date is [PII]. Uh, can you please check uh if the
[AGENT][NEUTRAL] Wait, hold on one second, hold on one second. The effective date is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Got it, [PII]. Thank you for that. And uh [PII], can you check if the, with the patient's name and date of birth for a new policy on file, if there is any for the current year?
[AGENT][NEUTRAL] Right, there's no other policies on file. This is the only policy they had with us.
[CUSTOMER][NEUTRAL] Got it, [PII]. Thank you for that. [PII], can you please provide me the uh reference number and the initial to your last name?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] Got that, [PII]. Thank you for that. You have a great time ahead.
[AGENT][NEUTRAL] You also, was there anything else I could assist you with today, [PII]?
[CUSTOMER][POSITIVE] No, no, I just had one member and uh thank you for assisting me. Have a great weekend. Bye-bye.
[AGENT][POSITIVE] You're welcome thanks
[AGENT][POSITIVE] You also, thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Yeah.