AccountId: 011433970860
ContactId: 879f48b2-a1f7-40e5-bb8a-25c993d8c59f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 230279 ms
Total Talk Time (AGENT): 78186 ms
Total Talk Time (CUSTOMER): 91588 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/879f48b2-a1f7-40e5-bb8a-25c993d8c59f_20250408T13:42_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Hi, good morning.
[CUSTOMER][NEUTRAL] Good morning [PII]. My name is [PII]. I'm calling from Miami vascular surgery office. I am calling because I wanna confirm if this um member secondary is active. It's coming out inactive for me.
[AGENT][NEUTRAL] OK, [PII], do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, thank you. Do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Yes, it's 241-938-9.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII], the date of birth is [PII].
[AGENT][NEUTRAL] OK. Yeah, I show this policy terminated, but let me see if there is another one.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, yes, there is a more current policy. Um, let me give you that policy number.
[CUSTOMER][NEUTRAL] OK, so there's a new policy?
[AGENT][NEUTRAL] Yes, um,
[CUSTOMER][NEUTRAL] Or is it just the same policy different member ID?
[AGENT][NEUTRAL] Different member ID same policy.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] And you're ready for that number?
[CUSTOMER][POSITIVE] Ready.
[AGENT][NEUTRAL] It's 2556492.
[AGENT][NEUTRAL] And this effective date, which is active [PII].
[CUSTOMER][NEUTRAL] OK, is there a term date?
[AGENT][NEUTRAL] No, it's active.
[CUSTOMER][NEUTRAL] OK, and then and something else, so she has a primary which is admin. He admin has a deductible of $6500 also a co-pay of 70. I'm wondering is that as a secondary, do you guys cover any of that?
[AGENT][NEUTRAL] Um, so yeah, let me pull up her benefits.
[AGENT][NEUTRAL] Um, this is not a guarantee of payment. It's a basic outline of the policy. Is this for outpatient services?
[CUSTOMER][NEUTRAL] Yes, I have, um, 2 CPT codes if you need.
[AGENT][NEUTRAL] Um, no, I yeah, I don't need codes, um, so for this policy it will cover up to 8700 per calendar year for outpatient services.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, 8000?
[AGENT][NEUTRAL] Yes, 8700.
[CUSTOMER][NEUTRAL] 8700 calendar year.
[CUSTOMER][NEUTRAL] Calendar year, um, has she met any of that?
[AGENT][NEUTRAL] Uh, let's see
[AGENT][NEUTRAL] I don't show anything's been used so far.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so basically she has 8700. That's what you guys cover up to, so I'm assuming that that's um also applies to her copay and deductible.
[AGENT][NEUTRAL] Yes, so under, so after primary processes the claim, whatever is left over, this could potentially apply towards co-pay, deductible co-insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK perfect can I have um can I have a reference number please?
[AGENT][NEUTRAL] Reference number is just my name, [PII], first initial, last name, [PII], and today's date.
[CUSTOMER][POSITIVE] Perfect thank you so much, [PII].
[AGENT][POSITIVE] Thank you. Have a great day. Thanks for calling APL.
[CUSTOMER][NEUTRAL] Have a, you too, bye bye.
[AGENT][NEUTRAL] Bye.