AccountId: 011433970860
ContactId: ba701ba4-80f2-4d4e-98df-97841d344ac1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 212589 ms
Total Talk Time (AGENT): 139316 ms
Total Talk Time (CUSTOMER): 56591 ms
Interruptions: 3
Overall Sentiment: AGENT=2.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/16/ba701ba4-80f2-4d4e-98df-97841d344ac1_20250616T16:10_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Hi, good afternoon, I'm calling for eligibility and benefits on a patient.
[AGENT][POSITIVE] OK, I'll be glad to help you. Go ahead and give me your name and the member's policy number, please.
[CUSTOMER][NEUTRAL] So it, it is [PII] and the policy number is 022.
[CUSTOMER][NEUTRAL] 191.
[CUSTOMER][NEUTRAL] 27
[CUSTOMER][NEUTRAL] [PII] 8.
[AGENT][POSITIVE] Alrighty, [PII], thank you so much for that information. Now while I'm pulling this up, go ahead and give me a good return telephone call number, please.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] All right, [PII], thank you
[AGENT][NEUTRAL] So much for all that information. Now your patient's name and date of birth today please?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Alrighty, thank you for all that information. [PII], looks like Gyro is the insured on this medical supplemental plan. I do show the original effective date as [PII]. Patient is still current and active, but I must step by that verification of coverage is not a guarantee of payment on the claim, but you did say you want benefits. Is that correct, [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, what type of benefit are you needing today, please, ma'am?
[CUSTOMER][NEUTRAL] It's gonna be ambulatory outpatient or colonoscopy preventative.
[AGENT][NEUTRAL] Alrighty, let me get that benefit pack pulled up. Now, of course, what we are is just the medical supplemental plan. So the only thing that we would pick up and pay on is anything that is applied towards the
[AGENT][NEUTRAL] Patients deductible copay or co-insurance at their primary insurance carrier. Now I do show that the effective date is [PII]. Patient is still current and active, but I must advise that verification of coverage is not a guarantee of payment on the claim, but you did want that.
[AGENT][NEUTRAL] An outpatient benefit for colonoscopy, correct.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Alrighty, because we don't pay for anything routine here at all. It would have to be for sickness and injury, and it would have to be applied towards that patient deductible copay or co-insurance. But should it be for an I mean an accident or sickness, then they would have a $500 benefit payable per calendar year under this plan.
[CUSTOMER][NEUTRAL] How can I help you?
[CUSTOMER][NEUTRAL] OK, is it still available?
[AGENT][NEUTRAL] That's per calendar day. That's, I'm sorry, I think I said per calendar year, but that is $500 per calendar day benefit.
[CUSTOMER][NEUTRAL] Oh OK OK no problem alright.
[AGENT][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] OK, and can I have a reference number?
[AGENT][NEUTRAL] OK, was there anything else that I can help you with?
[CUSTOMER][NEUTRAL] No, that should be all.
[AGENT][NEUTRAL] Well, we don't give reference number. OK, well, we don't give reference number, [PII], but you can use my name in today's date and my name is [PII] spelled [PII]
[CUSTOMER][NEUTRAL] OK, let me get you in our billing department. They're the ones who sent out the claims. Let me know when you're ready.
[CUSTOMER][NEUTRAL] Of course
[CUSTOMER][POSITIVE] OK perfect thank you so much have a great rest of your day.
[AGENT][NEUTRAL] Alright.
[AGENT][POSITIVE] Yes ma'am you as well.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][POSITIVE] And thanks for calling APU. Bye-bye.
[CUSTOMER][NEUTRAL] 954. Bye bye.