AccountId: 011433970860
ContactId: aa5e2046-041a-43ae-b475-f1281fcee2cd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 258380 ms
Total Talk Time (AGENT): 93118 ms
Total Talk Time (CUSTOMER): 86020 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/17/aa5e2046-041a-43ae-b475-f1281fcee2cd_20250317T17:08_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Good afternoon ma'am. My name is [PII] calling from the provider. I need to check and verify a patient benefits and eligibility please.
[AGENT][NEUTRAL] OK, you said your name was [PII]?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Do you have a phone number I can get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] Yes, ma'am. Without extension, it's [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Policy number I have is 251-31997.
[AGENT][NEUTRAL] Thank you [PII], hold on one moment please.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] It's uh [PII].
[AGENT][NEUTRAL] And the date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII], and you were needing benefits?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, I can help you with that. Is it for outpatient, inpatient or doctor's office?
[CUSTOMER][NEUTRAL] For hospital outpatient.
[AGENT][NEUTRAL] Outpatient.
[AGENT][NEUTRAL] OK, the effective date is [PII].
[AGENT][NEUTRAL] Any benefits given over the phones, not a guarantee of payment.
[AGENT][NEUTRAL] This policy coordinates with the primary insurance?
[AGENT][NEUTRAL] Whatever the primary applies to their deductible, co-pay or co-insurance, we'll pay up to $3500.
[CUSTOMER][NEUTRAL] Thank you. Um, is that the same with copay?
[AGENT][NEUTRAL] Right. Whatever their primary applies to their deductible co-pay or co-insurance will pick up up to that 3500.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] And uh would you be able to provide me any deductible and out of pocket?
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Hold on just a moment. I think I gave you the wrong benefit. I apologize for that.
[CUSTOMER][NEUTRAL] It's OK, ma'am.
[AGENT][NEUTRAL] That was, that was for inpatient. The outpatient is uh $500 per calendar day.
[CUSTOMER][NEUTRAL] Calendar day, got it.
[AGENT][NEUTRAL] Yes, ma'am. And what else were you needing?
[CUSTOMER][NEUTRAL] Uh, just wanted to know if you would be, uh, you would be able to provide me their deductible and out of pocket information.
[AGENT][NEUTRAL] I'm not showing they have a deductible.
[CUSTOMER][POSITIVE] Mhm thank you. How about the out of pocket?
[AGENT][NEGATIVE] They're responsible for whatever we don't pay past that $500. I mean, we don't have an out of pocket.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] This is just a secondary policy.
[CUSTOMER][POSITIVE] Got it thank you ma'am.
[CUSTOMER][NEUTRAL] Secondary policy. OK, got it. Thank you. So again, you have mentioned an effective date of uh [PII] and you covered $500 per calendar year, right?
[AGENT][NEUTRAL] For a calendar day.
[CUSTOMER][NEUTRAL] Oh, for calendar day. Sorry for that. Thank you. Can I have the call reference number, please?
[AGENT][NEUTRAL] We do not have call reference numbers you can use my name and today's date.
[CUSTOMER][POSITIVE] OK, got it thank you have a good day.
[AGENT][POSITIVE] Thank you [PII] for calling APL you as well.
[CUSTOMER][POSITIVE] Thank you, ma'am. Bye.
[AGENT][POSITIVE] Thank you.