AccountId: 011433970860
ContactId: 8758ba37-fb7e-4335-9ee3-ddce774793ac
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 283399 ms
Total Talk Time (AGENT): 131284 ms
Total Talk Time (CUSTOMER): 89030 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/8758ba37-fb7e-4335-9ee3-ddce774793ac_20250116T17:05_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from facility in order to check members' benefits and eligibility.
[AGENT][POSITIVE] OK, yeah, I'd love to help you with that today. You said your name was [PII], is that correct?
[CUSTOMER][POSITIVE] Yes, you are right. Yeah.
[AGENT][POSITIVE] Perfect thank you so much and may I have a good call back number real quick please?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] [PII] is a direct line number.
[AGENT][NEUTRAL] Thank you, sir. And what's that policy number?
[CUSTOMER][NEUTRAL] Yes, that policy number will be 02444783.
[AGENT][NEUTRAL] Perfect 02444783, is that correct?
[CUSTOMER][NEUTRAL] Yes, yeah.
[AGENT][NEUTRAL] All right, let me get that pulled on up for you, my friend, and.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] 1 2nd.
[AGENT][POSITIVE] Perfect. Would you be able to verify for me, pretty please, your patient's first and last name?
[CUSTOMER][NEUTRAL] Yeah, sure. That is [PII] with the date of birth [PII].
[AGENT][POSITIVE] Perfect.
[AGENT][NEUTRAL] All right. I do see [PII] here. She is current um with us and her policy effective date is [PII]. And you said you were looking for benefits as well, is that correct?
[CUSTOMER][POSITIVE] Yes, you are right.
[AGENT][POSITIVE] Perfect. And can I help you with inpatient or outpatient benefits today?
[CUSTOMER][NEUTRAL] Uh, I'm looking for outpatient hospital outpatient benefits.
[AGENT][POSITIVE] Perfect.
[AGENT][NEUTRAL] Um, I do wanna let you know any benefit information I give you over the phone will just be a verification of coverage and not a guarantee of payment. I have.
[AGENT][NEUTRAL] Um, outpatient benefits listed as.
[AGENT][NEUTRAL] $3000 per calendar year.
[CUSTOMER][NEUTRAL] OK. Is this a limited benefit plan?
[AGENT][NEUTRAL] Um, we're there supplemental policies, it's, uh, similar to a gap insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, may I know, is there any group number or group name for this?
[AGENT][NEUTRAL] Uh, yes, there should be both. I have the group number listed as 26143.
[AGENT][NEUTRAL] And then I have the group name listed as Practice Promotions LLC.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, I'm, I just need one clarification. You said the $3000 per candidate. What is the amount like deductable co-pay like that.
[AGENT][NEUTRAL] Oh, it's $3000 per calendar year.
[CUSTOMER][NEUTRAL] Yeah, I am, uh, may I know what type of amount is that?
[AGENT][NEUTRAL] Yeah, that's their benefit amount total, so we try to pick up and pay on things that major medical applies to their copay, coinsurance and deductible, um, and so they have up to $3000 within their policy, uh, as a benefit to, uh, help.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Close the gap from their major medical.
[CUSTOMER][POSITIVE] Yeah, got it.
[CUSTOMER][POSITIVE] Yeah, uh, well, thank you so much for that. Uh, may I know how much they may accumulated for as of now, uh out of $3000?
[AGENT][NEUTRAL] For the for the calendar year I can take a look at that for you.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] I am not showing anything um so far for the calendar year.
[CUSTOMER][NEUTRAL] Uh, as of now 0, am I right?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Got it. Thank you so much. May I get your name and call reference number for me accommodation purposes?
[AGENT][NEUTRAL] Oh yeah, you bet you. My name is [PII], first initial last name, [PII], and then the reference number is my name and today's date.
[CUSTOMER][NEUTRAL] Mm. Got it. Before ending of the call, I would like to check the subscriber name with you. Uh, the subscriber is [PII], and the date of birth [PII]. Am I right?
[AGENT][NEUTRAL] Yes, I do have [PII] [PII] correct.
[CUSTOMER][POSITIVE] Yeah, got it. Thank you so much, [PII]. Have a great day.
[AGENT][POSITIVE] My pleasure, thanks. You too.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Bye bye.