AccountId: 011433970860
ContactId: ab7cb337-23fe-4b59-a0e1-1fbbe11002f3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 117849 ms
Total Talk Time (AGENT): 56898 ms
Total Talk Time (CUSTOMER): 41661 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/ab7cb337-23fe-4b59-a0e1-1fbbe11002f3_20250313T15:16_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, this is [PII] with Rainer Eye Clinic in [PII]. I have a patient that has this as their gap plan. I'm trying to get benefits, please.
[AGENT][POSITIVE] All right, I'm happy to verify benefits today. Do you have their policy number?
[CUSTOMER][NEUTRAL] I got I have what she gave me it's 01009248.
[AGENT][NEUTRAL] OK, let me just pull this up here.
[AGENT][NEUTRAL] And if I can get the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] Thank you so much. So the patient is active. The effective date is [PII]. Uh, we are the secondary insurance, so it does cover deductible, co-pay, and co-insurance of primary doesn't.
[AGENT][NEUTRAL] And it looks like the patient plan has an outpatient benefit max for the calendar year of $3000.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Does she have to meet a deductible or anything like that?
[AGENT][NEUTRAL] Um, it looks like there is an outpatient deductible of $1000.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Is it 100% up to 3000 then or 8020 or?
[AGENT][NEUTRAL] Yeah, it would be 100% up to 3000.
[CUSTOMER][NEUTRAL] Up to the 3000. OK, let me write that down right quick.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] And $3000 and y'all don't require any kind of prior authorization or anything, do you?
[AGENT][NEUTRAL] No, we do not. Basically, we follow major medical. Major medical just has to pay for us to pay anything.
[CUSTOMER][POSITIVE] OK got you alright thank you so much I appreciate it.
[AGENT][POSITIVE] My pleasure. You have a good day.
[CUSTOMER][NEUTRAL] You as well bye bye.
[AGENT][NEUTRAL] Mhm. Bye bye.