AccountId: 011433970860
ContactId: 8858acf0-46c2-43fc-b11a-ad06170f6203
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 120319 ms
Total Talk Time (AGENT): 55139 ms
Total Talk Time (CUSTOMER): 65156 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/02/8858acf0-46c2-43fc-b11a-ad06170f6203_20250102T18:00_UTC.wav
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[AGENT][NEUTRAL] For calling APL, my name is [PII]. How may I assist you today?
[CUSTOMER][NEUTRAL] Hi [PII] with um Doctor um Doctor [PII]'s office. I just need to uh verify some coverage on the patient.
[AGENT][POSITIVE] I'd be happy to assist with eligibility today [PII], if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] Oh, it is 02061691.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient is [PII]. Birth date is [PII].
[AGENT][NEUTRAL] Thank you for that information. Please be advised the verification of coverage is not a guarantee of payment. I do show the policy is currently active. Effective date is [PII]. And are you calling for inpatient or outpatient benefits?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] For outpatient office I didn't know if this was an indemnity plan or or.
[AGENT][NEUTRAL] No, it's a gap plan, so we work in conjunction with her major medical.
[CUSTOMER][NEUTRAL] What does that mean? I'm sorry.
[AGENT][NEUTRAL] Meaning the meaning the claim goes to the major medical first once they assign patient responsibility, then it comes to us for um processing her patient responsibility. So we're her gap insurance.
[CUSTOMER][NEUTRAL] It's OK gap insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's what I needed to know because I thought well I'm not familiar with this one so.
[CUSTOMER][NEUTRAL] It comes to you all first, is that right? Is that what you said?
[AGENT][NEUTRAL] No, no, no, we're the gap, so it goes to the major medical first. Once they assign patient responsibility and um send the EOB to you, then you will send the claim in the EOB to us for processing.
[CUSTOMER][NEUTRAL] And then.
[CUSTOMER][POSITIVE] Oh, got you, now I understand. Alright, thank you very much.
[AGENT][NEUTRAL] Was there anything else I can assist with today?
[CUSTOMER][NEUTRAL] No, that's all I needed.
[AGENT][POSITIVE] Well thank you for calling APL you have a good day.
[CUSTOMER][NEUTRAL] Because I
[CUSTOMER][NEUTRAL] Mhm.