AccountId: 011433970860
ContactId: 787d69e5-cac5-4736-ae1a-b254b79c5738
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 150750 ms
Total Talk Time (AGENT): 59466 ms
Total Talk Time (CUSTOMER): 79193 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/26/787d69e5-cac5-4736-ae1a-b254b79c5738_20250226T19:15_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Hi [PII], I need to check eligibility and benefits for a plan, please.
[AGENT][POSITIVE] I'd be happy to assist with benefits and eligibility. May I have your first name please?
[CUSTOMER][NEUTRAL] My my name is [PII]. I'm gonna give you a disclaimer. I'm not sure if I'm in the right area.
[AGENT][NEUTRAL] OK if I can get a good.
[CUSTOMER][POSITIVE] It sounded OK.
[AGENT][POSITIVE] So I can get a good call back number for you?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] Policy number 02199679ML8.
[AGENT][NEUTRAL] Patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you for that information. Please be advised the verification of coverage is not a guarantee of payment, and you show the policy is currently active. Effective date is [PII].
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Alright, and do you show
[AGENT][NEUTRAL] And are you calling for inpatient or I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] Oh, no, no, you go ahead, I'm sorry.
[AGENT][NEUTRAL] Are you calling for inpatient or outpatient benefits?
[CUSTOMER][POSITIVE] It's got outpatient benefits.
[AGENT][NEUTRAL] I do show the outpatient calendar year maximum is $4000.
[CUSTOMER][NEUTRAL] Any coinsurance, deductible?
[AGENT][NEUTRAL] No, that, that will be questions for their major medical.
[CUSTOMER][NEUTRAL] She has this plan secondary to another commercial plan. You showed this policy as secondary?
[AGENT][NEUTRAL] Yes, we're always the gap we're the gap policy.
[CUSTOMER][NEUTRAL] OK, so what do you pick up following the primary insurance? I'm just not following how you said the 4000 max, or is your payout only 4000 after the after the primary? Oh, payout, OK. And do you know what's
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] We're, we pay for, we pay $4000 per year of per patient responsibility.
[CUSTOMER][NEUTRAL] Oh, OK, got you.
[CUSTOMER][NEUTRAL] Per year, got you.
[CUSTOMER][NEUTRAL] OK, do you know what the remaining amount is on that?
[AGENT][POSITIVE] She hasn't used any, she has a full amount available.
[CUSTOMER][NEUTRAL] Oh, OK, that's helpful. Alright, um, so whatever the deductible and co-insurance left behind by the primary, you guys will pay up to $4000.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][POSITIVE] OK, perfect. That's what I needed to know. What is your first name?
[AGENT][NEUTRAL] [PII] [PII]. Was there anything else I could assist with today?
[CUSTOMER][NEUTRAL] No, is there a reference number or anything, [PII]?
[AGENT][NEUTRAL] Just my name in today's date.
[CUSTOMER][POSITIVE] All right, thank you so much.
[AGENT][POSITIVE] Thank you for calling ATM. Have a good day.
[CUSTOMER][POSITIVE] Have a great day.
[CUSTOMER][POSITIVE] Thanks you too bye bye.