AccountId: 011433970860
ContactId: 9b7d6de7-e054-4c40-8f59-731cf25024ed
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 243970 ms
Total Talk Time (AGENT): 78317 ms
Total Talk Time (CUSTOMER): 98685 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/9b7d6de7-e054-4c40-8f59-731cf25024ed_20250523T16:18_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. My initial last is [PII]. Calling from the facility to get the benefit for a member.
[AGENT][NEUTRAL] OK. I can verify benefits for you, Ms. [PII]. And what is the policy number, please?
[CUSTOMER][NEUTRAL] OK, I will provide you that.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, let me check.
[CUSTOMER][NEUTRAL] OK. It is 01.
[CUSTOMER][NEUTRAL] 89
[CUSTOMER][NEUTRAL] 28
[CUSTOMER][NEUTRAL] 39
[CUSTOMER][NEUTRAL] M as in Mary, L as in Lima.
[CUSTOMER][NEUTRAL] 8
[AGENT][NEUTRAL] OK, thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] The callback number you want?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Yes. OK. It is [PII].
[AGENT][NEUTRAL] OK, thank you. And Ms. [PII], verify that patient's name, date of birth?
[CUSTOMER][NEUTRAL] It is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. I'm showing his effective date is [PII]. He is active on the policy and what benefits are you needing for this patient?
[CUSTOMER][NEUTRAL] OK. So for this member, I just wanna know that as a secondary insurance, it, it will be covered from the deductible and co-insurance or not?
[AGENT][NEUTRAL] For what type of services because this policy covers services inpatient or outpatient.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It is for the outpatient CT scan.
[AGENT][NEUTRAL] OK. Outpatient is covered under the policy, not a guarantee of payment, just verification of coverage. Patient has a benefit max up to 7500 per calendar year.
[CUSTOMER][NEUTRAL] OK, and, and how much patient is used for that?
[AGENT][NEUTRAL] Uh, one moment.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Uh, so far I show he's used $86828868.28.
[CUSTOMER][NEUTRAL] OK. But you told me it is 750 maximum, right?
[AGENT][NEUTRAL] 7500 per calendar year max for outpatient, and they have used 86828. Mhm.
[CUSTOMER][POSITIVE] OK, OK, OK, OK, OK, thank you. I really apologize for that.
[CUSTOMER][NEUTRAL] OK, that's, that was my fault.
[CUSTOMER][NEUTRAL] OK. Can you please spell out your name for me?
[AGENT][NEUTRAL] Sure, [PII] last initial [PII].
[CUSTOMER][NEUTRAL] OK. And what's the member's plan type for that? Can you please provide me that information?
[AGENT][NEUTRAL] Uh, their policy is a secondary supplemental plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And can you please provide me the reference number for this call?
[AGENT][NEUTRAL] Uh, we don't give reference numbers. If you like, you may use my name at today's date.
[CUSTOMER][POSITIVE] OK. Thank you so much for giving me that information. That's all for the day and have a good day. Bye-bye for now.
[AGENT][POSITIVE] Oh, you're welcome. Thanks for calling APL. Bye.