AccountId: 011433970860
ContactId: 83b62a5b-ff68-4e8d-a635-5be9e56d9cfb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 176699 ms
Total Talk Time (AGENT): 80191 ms
Total Talk Time (CUSTOMER): 65798 ms
Interruptions: 0
Overall Sentiment: AGENT=2.4, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/83b62a5b-ff68-4e8d-a635-5be9e56d9cfb_20250128T19:57_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. My name is [PII]. I'm calling from [PII].
[AGENT][NEUTRAL] OK, and how may I assist you today, Miss [PII]?
[CUSTOMER][NEUTRAL] Yeah, um, I was verifying this, um, the eligibility and benefits of the patient, and I forgot to ask if you guys will cover, like if the insurance still covers the Medicare deductible, even if the primary is out of network. Right?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Medicare deductible?
[AGENT][NEUTRAL] OK, I can check and see what type of product the member has, Miss [PII]. What is um a callback number just in case we get disconnected and the policy number?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah, it's gonna be 02454266 MLA.
[AGENT][NEUTRAL] OK. What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] and date of birth, [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so this um particular policy is the secondary supplemental plan to the major medical. The major medical for this member, Mr. [PII] is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. So, uh, OK, so what we do is we help with the co-payments, coinsurance and deductibles from the major medical. If the major medical don't pay, we do not pay. So they need to follow the uh major medical guidelines.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] So that means that if they're at a network with no benefits, you guys won't pay.
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][POSITIVE] All right, that'll be all. Thank you.
[AGENT][POSITIVE] You're welcome, Miss [PII]. Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Can I have the reference number? Can I have the reference number?
[AGENT][NEUTRAL] Oh, we don't have, we don't have reference numbers, Miss [PII]. You can use my name and today's date if you will. Do you need the spelling of my name or any other information?
[CUSTOMER][NEUTRAL] What's your name?
[AGENT][NEUTRAL] So, that's [PII].
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Bye bye.