AccountId: 011433970860
ContactId: b879d08a-5c07-4c99-a001-04570d78a4ca
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 339220 ms
Total Talk Time (AGENT): 154088 ms
Total Talk Time (CUSTOMER): 97056 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/b879d08a-5c07-4c99-a001-04570d78a4ca_20250110T22:40_UTC.wav
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[AGENT][POSITIVE] Good Afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm calling from UCSD Medical Center.
[CUSTOMER][NEUTRAL] Um, I was calling today to check on patients, um, insurance safe if it's active and to find out if authorization is.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, sure, I can assist you with the eligibility and authorization. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh yes, that is [PII].
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Uh, policy number is 021-984.
[CUSTOMER][NEUTRAL] ML8 hello? Yeah, I think my phone is having some issue.
[AGENT][NEUTRAL] Hello.
[AGENT][NEUTRAL] Um, yeah.
[AGENT][NEUTRAL] Yeah, I didn't get the last two digits of the policy.
[CUSTOMER][NEUTRAL] Um, ML 8.
[AGENT][NEUTRAL] Oh, I got the ML 8. I didn't get the last two digits. So before the email, the last two digits.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] 29
[AGENT][POSITIVE] 29. OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And let's see.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII], last name is [PII] [PII] [PII].
[AGENT][NEUTRAL] OK, thank you, Mr. [PII]. And what type of service is being under for benefits?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh, this is for ophthalmology under medical diagnosis.
[AGENT][NEUTRAL] OK, so it's for a Cygnus.
[AGENT][NEUTRAL] No routine.
[CUSTOMER][NEUTRAL] I'm sorry, what did you say?
[AGENT][NEUTRAL] It's for a Cygnus.
[CUSTOMER][NEUTRAL] I'm sorry, what did you say?
[CUSTOMER][NEUTRAL] What, what was that?
[AGENT][NEGATIVE] A sickness, it's not a routine, it's a sickness. Um.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] No, yes, yes, yes.
[AGENT][NEUTRAL] OK. All right. OK. Um, before I give you, um, any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. Um, this particular policy, uh, effective date is [PII]. It is active at the moment and this is one of our secondary supplemental plan to the major medical.
[AGENT][NEUTRAL] And with this one, we do cover office treatment or office procedures.
[AGENT][NEUTRAL] A rider and this is
[CUSTOMER][NEUTRAL] Sorry.
[AGENT][NEUTRAL] You, it's OK.
[CUSTOMER][NEUTRAL] That.
[CUSTOMER][POSITIVE] I'm so sorry.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] If you need to drink water, it's OK. I have.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] OK, good.
[CUSTOMER][NEUTRAL] Sorry.
[AGENT][NEUTRAL] Yes, OK, no problem. I understand. Trust me, I'm asthmatic, so I know how, how it is. OK, um.
[AGENT][NEUTRAL] So this particular policy has an office treatment writer or office procedure writer, um, which it covers um an outpatient maximum of $500 per day.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And what's the health plan called?
[AGENT][NEUTRAL] This is a secondary supplemental plan to the major medical.
[CUSTOMER][NEUTRAL] OK, so this one's secondary.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And what's the name?
[AGENT][NEUTRAL] Um, when you say the name, you mean the company's name or?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, yeah, this is, this is through American Public Life.
[CUSTOMER][NEUTRAL] The company's name.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Mhm. Yes, I'm still here.
[CUSTOMER][NEUTRAL] OK, there you are. Yeah, because my phone. What was your name?
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] My name is [PII]. That's [PII].
[CUSTOMER][NEUTRAL] OK, do you know his primary insurance?
[AGENT][NEUTRAL] Um, I can check and see, probably I have one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Cigna, Cigna is his major medical.
[CUSTOMER][NEUTRAL] Signal? I don't have that.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] You, would you happen to have the ID number?
[AGENT][NEUTRAL] No, we don't have that information. We only can see the name or who's the major medical. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Just write it down. Alright, perfect, thank you so much for your help. I appreciate it.
[AGENT][POSITIVE] You're welcome. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, that'll be it. Uh, do you have a reference number for our phone call?
[AGENT][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] We don't have reference numbers you can use my name in today's name.
[CUSTOMER][POSITIVE] OK perfect thank you so much have a great weekend.
[AGENT][POSITIVE] Mhm. You're welcome. You as well. Thank you for calling ATR Mrinia bye bye.
[CUSTOMER][NEUTRAL] Mhm bye bye.