AccountId: 011433970860
ContactId: a6872847-bbf4-4585-ad26-54c685fe30c6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 233889 ms
Total Talk Time (AGENT): 108195 ms
Total Talk Time (CUSTOMER): 57150 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/a6872847-bbf4-4585-ad26-54c685fe30c6_20250429T20:49_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, my name is [PII]. I'm calling to get eligibility and benefit information on the patient.
[AGENT][POSITIVE] OK, sure. I can assist you with benefits and eligibility, Mr. [PII]. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, Miss [PII]. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 01947042
[AGENT][POSITIVE] Thank you one moment.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] [PII] [PII].
[AGENT][POSITIVE] Perfect, thank you. And what type of services do you render for benefits this A?
[CUSTOMER][NEUTRAL] It's a um mammogram.
[AGENT][NEUTRAL] Is it a routine mammogram or is it a diagnostic mammogram?
[CUSTOMER][NEUTRAL] Dynastic.
[AGENT][NEUTRAL] All right. And um this is gonna take place in an outpatient facility or hospital?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. We have an effective date of [PII].
[AGENT][NEUTRAL] It is active at the moment and this is one of our secondary supplemental plans for the major medical. And we have an outpatient maximum of $80,050 per covered person per calendar year after a $100 deductible. Let me check and see if she already met the deductible. One moment.
[AGENT][NEUTRAL] Mm, she has not used her benefits, so she has um she still have that $100 deductible.
[CUSTOMER][NEUTRAL] You say she hasn't met the deductible?
[AGENT][NEUTRAL] Correct. She has not met the deductible.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] And um and you say this is secondary to, to the um primary, correct?
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Major medical
[AGENT][NEUTRAL] It is secondary to the major medical.
[CUSTOMER][NEUTRAL] Major medical, I'm sorry.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, I don't see that she have a.
[CUSTOMER][NEUTRAL] Primary insurance.
[AGENT][NEUTRAL] Let me see if I can find that information for you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm let's see.
[AGENT][NEUTRAL] Um, she is with the do off state benefits.
[AGENT][NEUTRAL] If it's
[AGENT][NEUTRAL] Allstate benefits.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I'll, I'm gonna, um, I'll just contact the patient to get that information.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome. Is there anything else I can help you with today, Miss [PII]?
[CUSTOMER][POSITIVE] Um, that's it. Thank you.
[AGENT][POSITIVE] You're welcome and thank you for calling APO. Have a good day, Miss [PII].
[CUSTOMER][NEUTRAL] You do too. bye bye.
[AGENT][POSITIVE] Thank you bye bye.