AccountId: 011433970860
ContactId: 841e4203-e44e-4ddc-96e3-f6c620a86acc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 165160 ms
Total Talk Time (AGENT): 84185 ms
Total Talk Time (CUSTOMER): 82684 ms
Interruptions: 1
Overall Sentiment: AGENT=2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/25/841e4203-e44e-4ddc-96e3-f6c620a86acc_20250225T17:01_UTC.wav
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[AGENT][POSITIVE] Good Morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Yes, hi, my name is [PII]. I'm calling to verify benefits for a patient, please.
[AGENT][POSITIVE] Sure, I can assist you with benefits, Miss [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] and
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] NC 6
[CUSTOMER][NEUTRAL] Yes, it is 02568971 M as in Mike L as in Lima 8.
[CUSTOMER][NEUTRAL] Got it, I'll get in so they last night.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And where are you calling from?
[CUSTOMER][NEUTRAL] I'm, I'm calling from Gastro Health.
[AGENT][NEUTRAL] What's the name of the facility?
[AGENT][NEUTRAL] As health, OK.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, thank you. May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII], [PII].
[CUSTOMER][NEUTRAL] Only isolating shower today. Temperatures.
[AGENT][POSITIVE] OK, perfect. Thank you. And um so you need outpatient benefits?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes, I have the patient scheduled for an outpatient upper endoscopy at an ambulatory surgery center, and I'm just calling to find out what this if this plan will cover anything towards that um procedure.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, all right, and before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. This is one of our secondary supplemental plans to the major medical and set up to help with the deductibles, co-payment and car insurance, and the amount that is payable on outpatient is $1500 per covered person per calendar year.
[CUSTOMER][NEUTRAL] I'm sorry, what was that amount?
[AGENT][NEUTRAL] 1500 per covered person per calendar year.
[CUSTOMER][NEUTRAL] Has she used any of that amount yet for this year?
[AGENT][NEUTRAL] I can check, let's see.
[CUSTOMER][NEUTRAL] Yeah, that's right we just heard from police within the hour to tell us that the victim and all the.
[AGENT][NEUTRAL] As of today, he has not used his benefits for [PII]. He still have the full amount available.
[CUSTOMER][NEUTRAL] So it goes towards co-pays, co-insurances, and then deductible, correct?
[AGENT][POSITIVE] Correct, yes.
[CUSTOMER][NEUTRAL] All right. And I'm sorry, your first name again was?
[AGENT][NEUTRAL] My name is [PII]. That's [PII].
[CUSTOMER][NEUTRAL] Allegedly
[CUSTOMER][NEUTRAL] And so may I get a reference number, please?
[AGENT][NEUTRAL] We don't have reference numbers you can use my name in today's date.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] Perfect. Thank you so much for your help. I appreciate that.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good day, Mr. [PII].
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][POSITIVE] Thank you. You too. Bye bye.
[AGENT][POSITIVE] You're welcome.