AccountId: 011433970860
ContactId: ad2f03ff-b5db-4148-a5c7-f869b6a254f3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 304239 ms
Total Talk Time (AGENT): 152937 ms
Total Talk Time (CUSTOMER): 70738 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/19/ad2f03ff-b5db-4148-a5c7-f869b6a254f3_20250619T18:39_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII].
[AGENT][NEUTRAL] May I help you today?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I am calling for benefits.
[AGENT][POSITIVE] Alrighty, [PII], I'll be glad to help you. Go ahead and give me the member's policy number.
[CUSTOMER][NEUTRAL] Yes, I have ID number.
[CUSTOMER][NEGATIVE] I don't know why they keep giving me these wrong ID numbers. Give me one second.
[AGENT][NEUTRAL] Alright, [PII], it's gonna be a certificate number.
[CUSTOMER][NEUTRAL] And that
[CUSTOMER][NEUTRAL] Yeah, and it's, it's cut off, the bottom is cut off, the outpatient benefit number is cut off.
[AGENT][NEUTRAL] Uh oh.
[CUSTOMER][NEUTRAL] Is it the same as the, is it the same as the hospital without the letters? Cause I have that one.
[AGENT][POSITIVE] Yes, yes, give me, go and give me that, [PII].
[CUSTOMER][NEUTRAL] OK, 0.
[CUSTOMER][NEUTRAL] 02450180.
[AGENT][NEUTRAL] Hm, let's see.
[AGENT][NEUTRAL] What's your patient's name?
[CUSTOMER][NEUTRAL] Um, this one is for [PII]. Date of birth [PII].
[AGENT][NEUTRAL] And that was [PII].
[CUSTOMER][NEUTRAL] Author
[AGENT][NEUTRAL] Alright, because yeah, I'm having this one too many numbers, but let me play with it and see if I can locate that. Let's see.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Uh, let me just try my name. So, hang on just a minute, [PII]. Let me see if I can find it another way. Oh, yes, ma'am.
[CUSTOMER][POSITIVE] No, take your time. Thank you.
[AGENT][NEUTRAL] And the first name is [PII] or [PII]?
[CUSTOMER][NEUTRAL] Author
[AGENT][NEUTRAL] Yeah, [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Is that [PII] have an S on it?
[CUSTOMER][NEUTRAL] It, uh, yes.
[AGENT][NEUTRAL] OK, well, I don't see anybody in my system about that. So you did say that policy number.
[AGENT][NEUTRAL] you're reading is 02450181?
[CUSTOMER][NEUTRAL] 80, so at the end it's a 0, so 02450180.
[AGENT][POSITIVE] Alrighty, I think I just had, yep, I found him.
[AGENT][NEUTRAL] Alrighty, and the date of birth again?
[CUSTOMER][NEUTRAL] I have here one second here, [PII].
[AGENT][NEUTRAL] Alrighty, thank you so much, [PII], for your patience and finding this patient. OK, looks like [PII] is the insured on this medical supplemental plan. Now, I do show the original effective date is [PII]. Patient is still current and active, but I must advise that verification of coverage is not a guarantee of payment on the claim, but you did say you want some type of benefit, [PII], is that correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] What type of benefit are you needing today?
[CUSTOMER][NEUTRAL] Coming in for an MRI of the lumbar, patient has a co-pay for the primary.
[AGENT][NEUTRAL] Oh, let me get that outpatient pulled up. Now, of course, what we are, [PII], is just the medical supplemental plan. So the only thing that we would pick up and pay on is anything that is applied towards patients deductible.
[AGENT][NEUTRAL] Pay our coinsurance and his primary insurance carrier for sickness and injury only nothing routine.
[AGENT][POSITIVE] It covered no matter what. Now his outpatient benefit here is gonna be no pre-cert, no deductible, and he has a $500 benefit payable per calendar day.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] And I am so sorry your name again.
[AGENT][NEUTRAL] My name is [PII], that's [PII] And is that all I can help you with today, [PII]?
[CUSTOMER][POSITIVE] No, I say, I spoke with you before. Thank you so much for all your help.
[AGENT][POSITIVE] Well, yes, ma'am, [PII], thanks for calling APO and you have a great rest of your day.
[CUSTOMER][POSITIVE] You do the same, stay safe.
[AGENT][POSITIVE] You as well. Thank you, ma'am. Bye bye.