AccountId: 011433970860
ContactId: b9b69b32-eb64-4070-916c-e3f35da46d22
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 219580 ms
Total Talk Time (AGENT): 76972 ms
Total Talk Time (CUSTOMER): 96829 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/b9b69b32-eb64-4070-916c-e3f35da46d22_20250620T18:15_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APR. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hi, [PII]. My name is [PII]. I'm calling from Memorial Herman. I was calling regarding a mutual patient I needed to verify some, uh, benefits for.
[AGENT][NEUTRAL] I'm sure [PII], I can assist you with benefits. Um, first, I'll need a good callback number just in case we're disconnected.
[CUSTOMER][NEUTRAL] Mhm. The direct contact number is [PII].
[AGENT][NEUTRAL] OK, thank you. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] 022.
[CUSTOMER][NEUTRAL] 800.
[CUSTOMER][NEUTRAL] Uh, give me one second, I'm sorry, um, 20.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] First name is [PII], um last name is [PII] Date of birth is [PII].
[AGENT][NEUTRAL] Thank you and just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII]. The policy is still active.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] You went out, can you repeat that for me please, the effective date?
[AGENT][NEUTRAL] It was [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. And the policy is still active. Um, is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, outpatient is gonna be for a diagnostic testing.
[AGENT][NEUTRAL] OK, for outpatient, we cover up to 3500 per calendar year and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim.
[CUSTOMER][NEUTRAL] OK, so a paying covers up to $3500 per year and that's for the primary co-pay, deductible and out of pocket.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, uh, no prior authorization required is secondary.
[AGENT][NEUTRAL] Right. Since we're secondary, we go by the primary insurance guidelines, so we don't require a prior authorization.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So a primary plan guideline.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] May I please have uh well you know I think I have it.
[CUSTOMER][NEUTRAL] The PO box address for claims, OK, I got that.
[AGENT][NEUTRAL] Would you like to verify it?
[CUSTOMER][NEUTRAL] OK. And Ms. [PII], may I please have
[CUSTOMER][NEUTRAL] Yes ma'am, give me one second, I have.
[CUSTOMER][NEUTRAL] So on the card, they have [PII].
[AGENT][NEUTRAL] OK. Yes, ma'am. It recently changed, so I was making sure that you have the new one and that's the correct one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's the correct one? OK, got it.
[AGENT][NEUTRAL] Right. Mhm.
[CUSTOMER][NEUTRAL] Alright, is there a call reference number or just your name in today's date?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, that'll just be my name in today's date. Um, is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Mm, first initial for your last name?
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][POSITIVE] OK thank you I appreciate it. Have a good day, Miss [PII].
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL. Mm bye.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm bye bye.