AccountId: 011433970860
ContactId: ab6ab4e1-f68e-4828-848b-98557dad457f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 197880 ms
Total Talk Time (AGENT): 59180 ms
Total Talk Time (CUSTOMER): 88827 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/03/ab6ab4e1-f68e-4828-848b-98557dad457f_20250603T19:25_UTC.wav
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[CUSTOMER][NEUTRAL] I know.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], good afternoon.
[CUSTOMER][NEUTRAL] I'm calling because I have a patient that wants to use this as a secondary to cover a co-payment she has with us for a biopsy. How do I know if this is her APL insurance covers for the co-pay?
[AGENT][NEUTRAL] Uh, do you have a policy number?
[CUSTOMER][NEUTRAL] Policy number for this is I have a group number that is that what you need? Payer ID?
[AGENT][NEUTRAL] Oh, there should be
[AGENT][NEUTRAL] Policy certificate number?
[CUSTOMER][NEUTRAL] I have on her card I have payer ID I have group number I have in hospital benefits certification outpatient benefit certification number.
[AGENT][NEUTRAL] Yeah, either one of those start numbers is fine.
[CUSTOMER][NEUTRAL] OK, you can put 02467408.
[CUSTOMER][NEUTRAL] MLA
[AGENT][NEUTRAL] OK, and then I, can I get your name and a good callback number?
[CUSTOMER][NEGATIVE] I'm sorry, you're breaking up. I cannot hear you.
[AGENT][NEUTRAL] Can I have your name and a good callback number?
[CUSTOMER][NEUTRAL] My name is [PII]. Callback is [PII].
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Her name is [PII]. Her date of birth I have. Give me one moment.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And you said it's benefits for outpatient services?
[CUSTOMER][NEUTRAL] Yes, freestanding facility outpatient services.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] This is not a guarantee of payment. It's a basic outline of the policy. Uh, it looks like your policy is active and effective [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, let's see.
[AGENT][NEUTRAL] Give me just a moment.
[AGENT][NEUTRAL] So for her policy, this will pick up any deductible, co-pay or co-insurance left over from the primary up to $750 per calendar day.
[CUSTOMER][NEUTRAL] OK, so it goes by day, so.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] If her co-payment with us is 1500.
[CUSTOMER][NEUTRAL] Would that 750 apply for that co-pay or it has to be the whole thing?
[AGENT][NEUTRAL] No, we would pay up to 750. Yes, we'd pay 750.
[CUSTOMER][NEUTRAL] Oh, OK, so she could still use, she can still use APL and then pay her out of pocket remaining?
[AGENT][NEUTRAL] Right. So if we receive the claim from you, um, for eligible charges, then we would pay a maximum of 750.
[CUSTOMER][NEUTRAL] The 750 and then her remaining will be 750. Alright, does this call have a reference number?
[AGENT][NEUTRAL] Uh, it's just my name and today's date.
[CUSTOMER][NEUTRAL] Can I have your name again please?
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][POSITIVE] Thank you [PII] so much have a nice day.
[AGENT][POSITIVE] Thanks for calling APL you as well. Bye-bye.
[CUSTOMER][NEUTRAL] Bye