AccountId: 011433970860
ContactId: b987927a-8d0b-43bc-96a1-1b3ed5be163a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 130320 ms
Total Talk Time (AGENT): 78527 ms
Total Talk Time (CUSTOMER): 38960 ms
Interruptions: 1
Overall Sentiment: AGENT=1.7, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/b987927a-8d0b-43bc-96a1-1b3ed5be163a_20250331T16:18_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm calling to get benefits on a patient.
[AGENT][POSITIVE] Sure, I can take benefits for you. Uh, what was your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, um, [PII], can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] Yes, it's [PII] and that's direct.
[AGENT][NEUTRAL] Thank you and then did you have that policy number?
[CUSTOMER][NEUTRAL] Yes, it's 01612907.
[AGENT][NEUTRAL] OK, and then, uh, what was the name and date of birth for the patient please?
[CUSTOMER][NEUTRAL] [PII] [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 the inpatient or outpatient benefits.
[CUSTOMER][NEUTRAL] It'll be outpatient for a CT scan?
[AGENT][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] And the patient does have UnitedHealthcare as primary.
[AGENT][NEUTRAL] Got it. OK, uh, so as long as they are willing to pay this policy can help, and of course I will let you know verification of coverage is not a guarantee of payment for claims. The outpatient benefit is $5000 max per calendar year, and they do have a $250 deductible that must be met first. If you'll give me one moment, I'll see if any of that has been used or met.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, nothing has been used or met so far this year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, so not until that deductible's met, it won't cover anything until the deductible's met, right? OK.
[AGENT][POSITIVE] Correct.
[AGENT][POSITIVE] Correct, yes.
[CUSTOMER][NEUTRAL] All right
[CUSTOMER][NEUTRAL] OK, and the initial of your last name?
[AGENT][NEUTRAL] Alright, was there anything else I can help you with? It's A.
[CUSTOMER][NEGATIVE] No thank you.
[CUSTOMER][NEUTRAL] Alright, and a reference call number?
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date.
[CUSTOMER][POSITIVE] OK, thank you so much. Have a good day.
[AGENT][POSITIVE] Alright, yeah, thanks for calling APL you too bye bye.
[CUSTOMER][NEUTRAL] Bye.