AccountId: 011433970860
ContactId: b8edbe92-9697-4da4-8d37-6e10364cacfd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 188550 ms
Total Talk Time (AGENT): 56862 ms
Total Talk Time (CUSTOMER): 63054 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/02/b8edbe92-9697-4da4-8d37-6e10364cacfd_20250502T14:12_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I was calling to get benefits for an outpatient surgery at an ambulatory surgery center.
[AGENT][NEUTRAL] OK, [PII], I can help you with benefits. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] OK, thank you. And do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Yes, the policy number I have is 02280020.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] The patient name is [PII]. His date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, this is not a guarantee of payment, basic outline of the policy. Policy is effective and active [PII].
[AGENT][NEUTRAL] And let me get that pulled up. One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And for their outpatient benefit, they have a $3500 per covered person per calendar year maximum benefit payout.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you need other information?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Hm, I just had a, a question. You may, you may be able to answer this for me. Did they, uh, does it say anything about the coordination of benefits? This was a secondary for the patient. I just wanted to make sure that it would cover the primary.
[AGENT][NEUTRAL] Um, I don't know about their, with their primary insurance will cover. Um, you'd have to verify benefits with them. I show it's Blue Cross Blue Shield.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, yeah, and I noticed that they still like a remaining deductible, so I just wasn't sure if the secondary would cover like this insurance would cover the remaining deductible or if they have to meet that in order for this one to even apply.
[AGENT][NEUTRAL] Uh, primary just has to consider the claim, so it has to be covered by primary, um, whether that's, so basically this is secondary, we'll pick up deductible co-insurance up to that $33,500 max.
[CUSTOMER][NEUTRAL] Got you. OK, OK. All right, I think that was all that I needed um do you happen to have a reference number?
[AGENT][NEUTRAL] That reference number is my name is [PII], first initial to last name [PII], and today's date.
[CUSTOMER][POSITIVE] OK, thank you so much [PII] um and I hope you have a great rest of your day.
[AGENT][POSITIVE] Thanks for calling APL. I hope you do too. Bye-bye.
[CUSTOMER][POSITIVE] Thank you bye bye.