AccountId: 011433970860
ContactId: 73dd1054-d8cf-4eae-9a08-773b1a79165c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 167649 ms
Total Talk Time (AGENT): 112660 ms
Total Talk Time (CUSTOMER): 42807 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=2.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/73dd1054-d8cf-4eae-9a08-773b1a79165c_20250305T22:01_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is. How may I help you today?
[CUSTOMER][NEUTRAL] Uh yes ma'am. I just needed uh benefits and eligibility, please.
[AGENT][POSITIVE] OK I'll be glad to help you. Go ahead and give me your name and the member's policy number, please.
[CUSTOMER][NEUTRAL] Hi, my name is [PII] and the member's policy number is 1116837.
[AGENT][NEUTRAL] Alrighty hey, thank you for that information. Now while I'm pulling this up, go ahead and give me a good return telephone call number please sir.
[CUSTOMER][NEUTRAL] Alright, it's [PII].
[AGENT][POSITIVE] Alright, thank you so much, [PII]. Now your patient's name and date of birth.
[CUSTOMER][NEUTRAL] Alright, it's gonna be [PII] [PII].
[AGENT][NEUTRAL] Alrighty thank you for all that information. Now you did say that you won't benefits, is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am. And uh in active date.
[AGENT][NEUTRAL] All right, let's see.
[AGENT][NEUTRAL] Oh, it looks like his effective date on this medical supplemental plan is.
[AGENT][NEUTRAL] [PII], to current policy is active, but I must advise that verification of coverage is not a guarantee of payment on the claim, but he is active and uh what exact type of benefit are you needing today, [PII]?
[CUSTOMER][NEUTRAL] Uh, we're looking at X-rays, essentially diagnostic X-rays, ultrasound, uh, uh, Coleman Regional Medical Center.
[AGENT][NEUTRAL] What's it gonna be done?
[AGENT][NEUTRAL] OK, so outpatient hospital. Alright, let's see, get that benefit pack pulled up.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] All right, now of course what we are is his medical supplemental plan, so the only thing that we would pick up and pay on is anything that is applied towards his deductible, co-pay, or co-insurance at his primary insurance carrier for sickness and injury. Only nothing routine here is covered no matter what. Now he is an outpatient benefit here is no pre-cert, no deductible, and a $2000 payable benefit per calendar year.
[CUSTOMER][NEUTRAL] OK, so to pay up 2000. Has he met any of that yet?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEGATIVE] No, sir, not as of today. He has not met any of that benefit as of today.
[CUSTOMER][POSITIVE] OK, good deal, so I'll cover that for you. What's a good reference number?
[AGENT][NEUTRAL] Mhm. We don't give reference number here, but you can use my name in today's date and my name is [PII] spelled [PII] And is that all that I can help you with today?
[CUSTOMER][POSITIVE] That's it, [PII]. I sure appreciate your help.
[AGENT][POSITIVE] OK. Well, yes, sir, and thanks for calling APO Heath and you have a great rest of your day.
[CUSTOMER][POSITIVE] You as well thank you bye bye.
[AGENT][POSITIVE] Thank you, sir. Bye-bye.