AccountId: 011433970860
ContactId: a82b7e46-b649-4567-a253-4d3b746115bb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 206199 ms
Total Talk Time (AGENT): 132376 ms
Total Talk Time (CUSTOMER): 45292 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/a82b7e46-b649-4567-a253-4d3b746115bb_20250121T19:37_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Hi, good afternoon, my name is [PII]. I was calling to get outpatient benefits for one of our patients.
[AGENT][POSITIVE] OK, [PII], I'll be glad to help you. Go ahead and give me a good policy number.
[CUSTOMER][NEUTRAL] It's 126. I'm sorry, it's 1256044.
[AGENT][NEUTRAL] Hi [PII], that was 01256044. Is that correct?
[CUSTOMER][NEUTRAL] 1256044.
[AGENT][NEUTRAL] Alrighty thank you for that information, [PII]. Now while I'm pulling this up, go ahead and give me a good return telephone call number please ma'am.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] Alright [PII], thank you so much for all that information. Now your patient's name and date of birth today, please.
[CUSTOMER][NEUTRAL] It's [PII] [PII].
[AGENT][NEUTRAL] Alrighty [PII], thank you for all that information. Looks like Marjorie is the insured on this medical supplemental plan. I do see this number is terminated, so let me go and see if she flipped to a different number. So bear with me just one moment. Let's see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Looks like maybe she did so let me get it pulled up let's see.
[AGENT][NEUTRAL] Excuse me.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yep, looks like she did flip to a different number, so I'm gonna give you the correct policy number that is current here at APL.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that policy number is 022.
[AGENT][NEUTRAL] 95,810.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Yes ma'am, I do show that this, uh, effective date on this medical supplemental plan [PII], it is current and active, but I must advise that verification of coverage is not a guarantee of payment on a claim, but you did say you want some type of benefit. Is that correct, [PII]?
[CUSTOMER][NEUTRAL] Yes, for all patients.
[AGENT][NEUTRAL] Alright, well you haven't done outpatient.
[CUSTOMER][NEUTRAL] Uh, ultrasound.
[AGENT][NEUTRAL] Alright, let's see, get that benefit pack pulled up now. What we are Leah is of course her medical supplemental plans, so the only thing that we will pick up and pay on is anything for sickness and injury that is applied towards her deductible copay or co-insurance at her primary insurance carrier and her outpatient benefit here is a zero deductible, no pre-cert, and a $3500 outpatient benefit payable per calendar year.
[CUSTOMER][NEUTRAL] OK, and then has she used up um her any of her benefits for the new calendar year?
[AGENT][NEUTRAL] See.
[AGENT][NEGATIVE] No ma'am, looks like she's not used any benefit uh for [PII] as of today.
[CUSTOMER][POSITIVE] Perfect. Alrighty, um, those are the only questions that I had. Thank you so much for your help, OK?
[AGENT][POSITIVE] Well, yes ma'am, Lean, is that all I can help answer for you today?
[CUSTOMER][NEUTRAL] Yes, that'll be all.
[AGENT][POSITIVE] Alright, yes ma'am, [PII], thanks for calling APO. You have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you. You too. Bye.
[AGENT][POSITIVE] Thank you ma'am bye bye.