AccountId: 011433970860
ContactId: 7931d9fc-a27e-4611-8ee5-1c8474353e24
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 190350 ms
Total Talk Time (AGENT): 101423 ms
Total Talk Time (CUSTOMER): 82146 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/7931d9fc-a27e-4611-8ee5-1c8474353e24_20250305T18:17_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII] with um Lakeview Physician Group. Can I, or actually we're LCMC Medical group now. Can I ask, [PII], do you spell your first name with a [PII] or a [PII]?
[AGENT][NEUTRAL] It's [PII] I'm sorry, what did you say your name was?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] [PII], OK.
[CUSTOMER][NEUTRAL] I'm just calling, I'm calling to verify um a coverage for a patient who's coming in here soon.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, yeah, I could check eligibility for you. Um, can I get a good call back number from me first in case we're disconnected?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Sure. Yes, ma'am. It's [PII].
[AGENT][NEUTRAL] OK, thank you and then do you have that policy number?
[CUSTOMER][NEUTRAL] Yes, 203-200-074.
[AGENT][NEUTRAL] OK, um, that's a bit too long to be one of our policy numbers, [PII]. That was, you said 203-20074?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] 2 I'm sorry 023.
[CUSTOMER][NEUTRAL] 20074
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][POSITIVE] I can pull the chart back up. I can pull the chart back up if I need to.
[AGENT][NEUTRAL] No, I think that did it. OK, yeah, the 2 and the 0 were mixed up. Uh, what was the name and date of birth for the insured, please?
[CUSTOMER][NEUTRAL] Um, [PII], date of birth [PII].
[AGENT][NEUTRAL] Got it. OK, thank you for verifying that, [PII]. So this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, alrighty.
[CUSTOMER][NEUTRAL] Alright perfect and then there's no um co-pay or deductible for this plan it's just a gap plan.
[AGENT][NEUTRAL] Let me make sure I think they do have an outpatient deductible.
[AGENT][NEUTRAL] Let's see for.
[CUSTOMER][NEUTRAL] Uh, yeah, we're, yeah, we're we're outpatient PCPs.
[AGENT][NEUTRAL] OK, bear with me just a moment. Yes, so, um, and of course I will let you know verification of coverage is not a guarantee of payment for claims. So they do have an outpatient deductible, um, in regard for excuse me, accident and sickness, um, that would be a deductible of $100. Their total outpatient benefit is $6000 per calendar year.
[CUSTOMER][NEUTRAL] OK, alright.
[AGENT][NEUTRAL] If you give me one moment, I'll see if that has been met or if any of that benefit has been used.
[CUSTOMER][POSITIVE] Perfect, perfect.
[AGENT][NEUTRAL] OK, no, I'm not showing that any of that has been used.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, and then the only thing else I need would be um the first initial of your last name and a reference number if you have one, or do I need just use your name and date of date date?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] A reference number would just be my first name, last initial, and today's date. Uh, so my last name, or excuse me, last initial is [PII] Was there anything else I could help you with, [PII]?
[CUSTOMER][POSITIVE] OK, no care, that was all I needed. Thank you very much, appreciate it. You have a great day.
[AGENT][POSITIVE] Alright, yeah, thanks for calling. You too, bye bye.
[CUSTOMER][POSITIVE] Thanks bye bye.