AccountId: 011433970860
ContactId: b757ccaf-e8e5-4829-ad6f-34d96039c0cd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 165759 ms
Total Talk Time (AGENT): 70063 ms
Total Talk Time (CUSTOMER): 53378 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/b757ccaf-e8e5-4829-ad6f-34d96039c0cd_20250110T15:38_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] [PII], I'm just checking on a patient's eligibility for um their meta gap.
[AGENT][NEUTRAL] OK, I can help you with the eligibility. Can I please get your name and your callback number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure, my name is [PII], last initials [PII]
[CUSTOMER][NEUTRAL] And my callback direct line is [PII].
[AGENT][NEUTRAL] Thank you, Ms. [PII]. What is the patient's name?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] OK, and what's [PII]'s date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then her policy number, please.
[CUSTOMER][NEUTRAL] Uh, we have 01457121.
[AGENT][NEUTRAL] OK, let me pull that in real quick.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, I do show that [PII] does have an active policy and her effective date is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else that you might need me to look up for you, Ms. [PII]?
[CUSTOMER][NEUTRAL] Um, yeah, the out of pocket max for this, um, how much does it cover? I know she's got like a $3000 deductible on her, um, primary insurance, so I wanted to know how much this will cover on that.
[AGENT][NEUTRAL] Right, OK, and this is just to verify her coverage. It's not a guarantee of payment. She has an inpatient calendar year benefit amount of 2500, and then she also has an outpatient calendar year benefit amount of $2500 that helps with deductible copay or co-insurance.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, and she's got all of it left I assume because it started over.
[AGENT][NEUTRAL] Let me double check for you.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Um, I'm going to say yes, but I wanna make sure.
[CUSTOMER][NEUTRAL] OK, that's fine.
[AGENT][NEUTRAL] Yes ma'am, she has it all left.
[CUSTOMER][NEUTRAL] OK, so 2500, OK.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] All right, OK, and can I get a reference?
[AGENT][NEUTRAL] Yes, ma'am, you can use my name [PII] and today's date.
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][POSITIVE] OK, that's great thanks so much for your help [PII] have a great day.
[AGENT][POSITIVE] You too and you have a wonderful weekend thanks for calling APL.
[CUSTOMER][NEUTRAL] You too
[CUSTOMER][NEUTRAL] Bye bye.