AccountId: 011433970860
ContactId: 85b891f1-6b26-4e5f-ac21-274a058c4598
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 166229 ms
Total Talk Time (AGENT): 96154 ms
Total Talk Time (CUSTOMER): 57030 ms
Interruptions: 0
Overall Sentiment: AGENT=3.7, CUSTOMER=1.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/85b891f1-6b26-4e5f-ac21-274a058c4598_20250211T15:47_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] Yes.
[CUSTOMER][NEUTRAL] Hi [PII], good morning. um, I'm calling for outpatient benefits for a patient, please.
[AGENT][POSITIVE] OK, I'd be glad to help you. Go ahead and give me uh your name and the member's policy number, please.
[CUSTOMER][NEUTRAL] Of course. My name is [PII]
[CUSTOMER][NEUTRAL] And the member's policy is 02549577.
[CUSTOMER][NEUTRAL] M as in Mary, L as in Lima, 8.
[AGENT][POSITIVE] All right, [PII], thank you so much for that information. Now while I'm pulling this up, go ahead and give me a good return telephone call number, please.
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[AGENT][POSITIVE] Alright, thank you so much [PII], for all that information. Now what's your patient's name and date of birth today please ma'am?
[CUSTOMER][NEUTRAL] It's [PII]. Date of birth [PII].
[AGENT][NEUTRAL] All right, it looks like Dawn is the insured on this medical supplemental plan. I do show the original effective date is [PII]. It is current and active, but of course I must advise that verification of coverage is not a guarantee of payment on a claim, but you did say you want some type of benefits. Is that correct?
[CUSTOMER][NEUTRAL] Yes, please, outpatient surgical.
[AGENT][NEUTRAL] are you calling from the hospital or doctor's office, [PII]?
[CUSTOMER][NEUTRAL] From an ambulatory surgery center actually.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alrighty, let me get that benefit pulled up. Now, of course, what we are is just her medical supplemental plan. So the only thing that we will pick up and pay on is anything for sickness or injury that is applied towards her deductible copay or co-insurance at her primary insurance carrier. Nothing routine here is covered no matter what. Her outpatient benefit here is a zero deductible, no pre-cert with a $3000 max benefit payable per calendar day.
[CUSTOMER][POSITIVE] Perfect. OK, sounds great. And would you please be able to provide me with um the spelling of your name and um
[CUSTOMER][NEUTRAL] And the reference number?
[AGENT][POSITIVE] Yes, ma'am, and is that all that I can help you with?
[CUSTOMER][POSITIVE] Yes, that's it thank you.
[AGENT][NEUTRAL] Alrighty. Yes, ma'am. We don't give reference numbers, but you can use my name in today's date, [PII], and my name is spelled [PII]
[CUSTOMER][POSITIVE] Awesome thank you so much I appreciate your help.
[AGENT][POSITIVE] Yes, ma'am, and thank you for calling APL Carry. You have a great rest of your day.
[CUSTOMER][POSITIVE] You as well thank you.
[AGENT][POSITIVE] Thank you, ma'am. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.