AccountId: 011433970860
ContactId: b50e16a9-211b-4b56-b8fe-7856bcf06e4f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 288549 ms
Total Talk Time (AGENT): 128475 ms
Total Talk Time (CUSTOMER): 98166 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/13/b50e16a9-211b-4b56-b8fe-7856bcf06e4f_20250113T19:41_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], how are you for verification?
[AGENT][POSITIVE] I'm good. How are you?
[CUSTOMER][NEUTRAL] On a patient?
[CUSTOMER][POSITIVE] I'm good thank you for asking.
[AGENT][POSITIVE] All right. I'm happy to check verification eligibility. What's the uh policy number?
[CUSTOMER][NEUTRAL] OK, give me one moment so to be completely honest with you, I've never seen it like this and there's an in hospitals benefit certification number or outpatient benefit number.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] OK, yeah, you can honestly, you can give me either one of those. I should be able to pull it with that.
[CUSTOMER][NEUTRAL] OK, 0202298583 ML 7.
[AGENT][NEUTRAL] All right, thank you for that. And then if you don't mind, can I grab your first name and a callback number?
[CUSTOMER][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] Yes, [PII]
[CUSTOMER][NEUTRAL] Callback number would be [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. Uh, what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] The name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Thank you so much. So the patient's plan is active. The effective date on this, if you need it, is [PII]. We are the secondary insurance, so this is gonna cover deductible, co-pay, and co-insurance that their primary does not.
[AGENT][NEUTRAL] And it looks like the outpatient, if that's what we're looking for Benefit max for the calendar year is $3000.
[CUSTOMER][NEUTRAL] OK, give me one moment so I can put either of these numbers as.
[CUSTOMER][NEUTRAL] The ID number. The thing is we wanna know if we take it. We have her primary, which is the United, but we do know you guys come out as the secondary, um, and it's for dermatology visit.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yeah, so you can definitely put down that number that you gave me as the policy number for sure, that'll work, yeah.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, and would you guys cover any of this for her?
[AGENT][NEUTRAL] Let me see. It may cover treatment. It may not cover the actual office visit itself, like the fee. Let me double check really quick.
[CUSTOMER][POSITIVE] And if I can have your name again I'm sorry to place it here.
[AGENT][NEUTRAL] No, that's all right. My name is [PII], that's [PII]
[CUSTOMER][NEUTRAL] Perfect 0.
[AGENT][NEUTRAL] OK, so yeah, it looks like it's not gonna cover the office visit fee.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] Um, but it won't cover any sort of treatment in office.
[CUSTOMER][NEUTRAL] OK, and there would be a deductible for that?
[AGENT][NEUTRAL] Mm mm. There's no deductible, I don't think on this plan. Let me just double check.
[AGENT][NEUTRAL] Yeah, there's no deductible on the plan.
[CUSTOMER][NEUTRAL] OK, and would there be a coinsurance?
[AGENT][NEUTRAL] Mm mm.
[CUSTOMER][NEUTRAL] So for this one specifically what would I put?
[CUSTOMER][NEUTRAL] Then we would just have to send this to you.
[AGENT][NEUTRAL] So you guys would build their primary insurance first and then anything residual left over we would pick up for treatment. The patient would be responsible for whatever the copay is for their office visit, the fee and we're not gonna cover that.
[CUSTOMER][POSITIVE] OK perfect so she is.
[CUSTOMER][NEUTRAL] OK perfect and then you guys would cover up to 3000?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, no problem. Can I go ahead and have a reference number to this call?
[AGENT][NEUTRAL] Absolutely [PII], that's gonna be my name with my last initial and then today's date. My name again is [PII], last initial [PII], and then just today's date.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You're welcome have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.