AccountId: 011433970860
ContactId: 7b1a95cb-40b3-4708-9024-c117a150ed7d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 244899 ms
Total Talk Time (AGENT): 144154 ms
Total Talk Time (CUSTOMER): 54179 ms
Interruptions: 1
Overall Sentiment: AGENT=1.4, CUSTOMER=1.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/02/7b1a95cb-40b3-4708-9024-c117a150ed7d_20250602T14:37_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Hi, good morning. I'm calling to verify benefits for your patient.
[AGENT][POSITIVE] OK, I'll be glad to help you. Go and give me your name and the member's policy number, please.
[CUSTOMER][NEUTRAL] [PII] policy is 02266030 ML8.
[AGENT][NEUTRAL] All right, [PII], thank you for that information. Now while I'm pulling this up, go ahead and give me a good return telephone call number, please.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Alrighty, thank you for that, [PII]. Let's see.
[AGENT][NEUTRAL] All right, your patience, name and date of birth today, please?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Alrighty. Thank you, [PII]. It looks like [PII] is the insured on this medical supplemental plan. I do see this policy number is terminated, so let me see if she flipped to a different number right quick. I think she has.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Yeah, looks like she did flip to a different number that's active. So [PII], first off, I'm gonna give you the correct policy number. It's gonna be 02.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Baba.
[AGENT][NEUTRAL] 6451.
[AGENT][NEUTRAL] And I do show this medical supplemental plan went into effect [PII]. It is current and active, but I must advise that verification of coverage is not a guarantee of payment on the claim, but you did say you want some type of benefit. Is that correct, [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, what type of benefit are you needing?
[AGENT][POSITIVE] Good day, please?
[CUSTOMER][NEUTRAL] So before we move on, it's the, the policy number, the new one is 02556451. Does it have that MLA at the end or no?
[AGENT][POSITIVE] Correct
[AGENT][NEUTRAL] Yes, mhm, yes.
[CUSTOMER][NEUTRAL] OK. Um, the benefits I'm looking for are for ambulatory surgical center, non-hospital based outpatient.
[AGENT][NEUTRAL] Alrighty, let me get over to that benefit pack. Let's see.
[AGENT][NEUTRAL] All right. Now of course what we are is just her medical supplemental plan. So the only thing that we would pick up and pay on is anything for sickness and injury that is applied towards her deductible, co-pay, or co-insurance and her primary insurance carrier, nothing routine here is covered no matter what. Now her benefit here for outpatient is going to be no pre-cert.
[AGENT][NEUTRAL] Zero deductible, and she has a maximum of $8700 payable per calendar year.
[CUSTOMER][NEUTRAL] OK, has any of that been used?
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Looks like as of today, she's used only $95 of her benefit.
[CUSTOMER][POSITIVE] OK, perfect, thank you so much and can I have your name again and a reference number?
[AGENT][NEUTRAL] All right, is that, yes, ma'am.
[AGENT][NEUTRAL] Well, is that all that I can answer for you today, [PII]?
[CUSTOMER][POSITIVE] Yeah, that would be all thank you.
[AGENT][NEUTRAL] Well, yes, ma'am, we don't give reference numbers, um, [PII], but you can use my name and today's date and my name is [PII] spelled [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Thank you so much you have a wonderful day.
[AGENT][POSITIVE] You as well, [PII], and thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.