AccountId: 011433970860
ContactId: a2d599eb-a829-4095-842e-d396b20ce6de
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 169100 ms
Total Talk Time (AGENT): 95468 ms
Total Talk Time (CUSTOMER): 63893 ms
Interruptions: 1
Overall Sentiment: AGENT=1.5, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/25/a2d599eb-a829-4095-842e-d396b20ce6de_20250225T13:48_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][POSITIVE] Hi there, I'm just trying to get some uh medical benefits for a new patient of ours.
[AGENT][POSITIVE] It would be my pleasure to assist you with those benefits. May I ask your name?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][POSITIVE] Thank you, [PII]. What is a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, it is 025815887.
[AGENT][NEUTRAL] And the patient's name and date of birth, please, ma'am?
[CUSTOMER][NEUTRAL] April, right, um, [PII].
[AGENT][NEUTRAL] All right, thank you. Oh, I wonder if she was named April because of it. I'm sorry.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] I know, I wondered that too. I did. I was like, oh, that's cute. I like it.
[AGENT][NEUTRAL] That is you.
[AGENT][NEUTRAL] I can never forget what month she was born in.
[CUSTOMER][NEUTRAL] Yep.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] I bet her parents did that as a, as a, a trick to remember her birthday.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Probably.
[AGENT][NEUTRAL] Probably. Well, I can help you with that eligibility and benefits. Her policy is active with the effective date of [PII].
[AGENT][NEUTRAL] Now this is a secondary policy to the policyholders' Major medical.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Are there specific benefits you're needing?
[CUSTOMER][NEUTRAL] Well yeah she's coming in for a um an in office procedure and um I just don't know if you guys are gonna pick up the copayment.
[AGENT][NEUTRAL] So with her policy, it does pay to the major medical deductible co-pay or co-insurance. Now, the visit would not be covered.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But for procedure or treatment in office.
[AGENT][NEUTRAL] That could be considered for benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that benefit amount is.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sorry, you have to get back to that screen. The benefit amount is $250. That is a per calendar day benefit.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that is a verification of coverage and not a guarantee of payment.
[CUSTOMER][POSITIVE] OK, that's all I needed thank you so much I appreciate it.
[AGENT][POSITIVE] My pleasure to help you with that eligibility and benefit by. Sure.
[CUSTOMER][NEUTRAL] Oh, you know what?
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] One more thing I'm so sorry, one more thing, do you, do you want us to mail claims or do you have an electronic ID?
[AGENT][NEUTRAL] So you can mail, you can send it electronically or you can fax it. Our payer ID is 60801.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect. OK, that's what I needed. Thank you so much for your help.
[AGENT][POSITIVE] And thank you for calling APO you have wonderful day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye