AccountId: 011433970860
ContactId: 863f63fa-5473-4bcf-9968-5b8a67345c74
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 172889 ms
Total Talk Time (AGENT): 86926 ms
Total Talk Time (CUSTOMER): 79098 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/23/863f63fa-5473-4bcf-9968-5b8a67345c74_20250423T14:52_UTC.wav
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[AGENT][POSITIVE] Thank you for calling.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] How are you? I'm, I'm calling to find out a patient's eligibility.
[AGENT][NEUTRAL] OK, may I have your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK, give me one second, [PII], thank you, and your callback number?
[CUSTOMER][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] Thank you so much, and may I have the policy number please?
[CUSTOMER][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] Yes, the policy number is 00945121.
[AGENT][POSITIVE] Thank you so much. Verify the patient's name and date of birth. Thank you.
[CUSTOMER][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] [PII] is the last name and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you very much for the information and you're calling to check eligibility for the member. OK, one moment. Thank you, thank you. And the policy shows effective as of [PII] I'm sorry [PII], and this policy shows active for him.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] OK, Thursday.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] What kind of plan is it?
[AGENT][NEUTRAL] This is a supplemental medical policy.
[CUSTOMER][NEUTRAL] A supplemental medical policy.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Alright, does he, does he have any um out of network benefits or co-insurance or anything?
[AGENT][NEUTRAL] Um, we do not follow a network of providers.
[CUSTOMER][NEUTRAL] Or it just follows.
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] Is it for an office visit? Is it for an office visit or?
[CUSTOMER][NEUTRAL] It's for a lab testing.
[AGENT][NEUTRAL] OK, so let me check to see if there's a lab, but what it is is to supplement the policy we help with the major medical deductible co-pay and co-insurance based on coverage with us, and I can check to see if there's any lab work on here, lab, it does not cover lab.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It does not cover labs, OK. It's a major medical, um, OK. So it's something sort of like a um a Medicare supplemental but for private insurance?
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] No, it's a major medical supplemental, um, it's just that this particular policy does not cover lab or office visits. It covers places of service. Yes, it covers places of service such as, um, ER, urgent care, um, hospital outpatient facility, um, ambulatory surgical facility, diagnostic testing facility.
[CUSTOMER][NEUTRAL] Or office visits.
[CUSTOMER][NEUTRAL] OK. It, cause it's, it's under diagnostic testing, like lab test, but it won't probably be covered. OK, no problem. Um, can I get your name and the reference number?
[AGENT][NEUTRAL] My name is [PII]. We do not use reference numbers, but you can use my name in today's date, [PII], and my last initial is [PII], yes.
[CUSTOMER][NEUTRAL] And today's date.
[CUSTOMER][POSITIVE] OK beautiful thank you so much, [PII]. Have a good day.
[AGENT][POSITIVE] You're welcome. You too, thanks for calling APL.
[CUSTOMER][NEUTRAL] All right. Bye-bye.
[AGENT][NEUTRAL] Bye.