AccountId: 011433970860
ContactId: b29f5eec-9a02-43e2-b1d8-231b9701c1a1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 161130 ms
Total Talk Time (AGENT): 85589 ms
Total Talk Time (CUSTOMER): 54524 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/b29f5eec-9a02-43e2-b1d8-231b9701c1a1_20250303T20:16_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, I need benefits please or to see if this is like uh a um legit secondary insurance for this patient.
[AGENT][NEUTRAL] Sure, I could check eligibility and benefits for you. um, what was your name?
[CUSTOMER][NEUTRAL] [PII]?
[AGENT][NEUTRAL] OK, [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. Do you have the policy number?
[CUSTOMER][NEUTRAL] 02581675
[AGENT][NEUTRAL] OK, and then, uh, what was the name and date of birth for the insured please?
[CUSTOMER][NEUTRAL] [PII] and the date of birth is.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Perfect, thank you for verifying that, [PII]. Uh, so this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays. And we really need to look at uh outpatient or inpatient benefits.
[CUSTOMER][NEUTRAL] Outpatient?
[AGENT][NEUTRAL] OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims, so their outpatient benefit is on a per calendar day basis it would pay up to $250 max per calendar day.
[CUSTOMER][NEUTRAL] So, he can use it for surgery, like,
[AGENT][NEGATIVE] Yeah, any, any sort of outpatient procedure as long as major medical uh contributes. If major medical does not pay, this policy can't.
[CUSTOMER][NEUTRAL] OK, so, um, you guys cover up to $250 per day.
[AGENT][POSITIVE] Yes, for the outpatient benefit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] As long as the primary pays.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, and what was your name, initial to your last name, and a reference number?
[AGENT][NEUTRAL] Sure, reference number would just be my first name, last initial, and today's date. Uh so my name is spelled [PII] Was there anything else I could help you with, [PII]?
[CUSTOMER][NEUTRAL] Uh, let me just clarify that the claims address is [PII].
[AGENT][NEUTRAL] Yes, um, I've also got a fax number and a payer ID if you'd like.
[CUSTOMER][NEUTRAL] OK, what is the payer ID?
[AGENT][NEUTRAL] That is 60801.
[CUSTOMER][POSITIVE] OK, alright, that's it thank you.
[AGENT][POSITIVE] Alright, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] You too thank you bye.
[AGENT][POSITIVE] Thank you, bye bye.