AccountId: 011433970860
ContactId: bb2d7a6f-1cdf-4b78-b9e8-69c1540de667
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 285850 ms
Total Talk Time (AGENT): 113461 ms
Total Talk Time (CUSTOMER): 98544 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=2.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/bb2d7a6f-1cdf-4b78-b9e8-69c1540de667_20250326T16:43_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, [PII]. My name is [PII]
[CUSTOMER][NEUTRAL] Initial for my last name is [PII]. I'm calling to check benefits for a patient.
[AGENT][NEUTRAL] OK, Miss [PII], I can help you with benefits. Can I please get your call back number and the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Yes, callback number is [PII].
[AGENT][POSITIVE] Thank you, ma'am.
[AGENT][NEUTRAL] And then what is the name of the facility you're calling from, Miss [PII]?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] This is South Florida EMT Associate Officer Doctor [PII].
[AGENT][NEUTRAL] OK, thank you. And then can you please give me the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Patient's name, uh, let me give you the policy number first is 02153574 M as in Mary, L as in Louis number 8. Patient's name is [PII], [PII].
[AGENT][NEUTRAL] OK, let me pull up that policy for us real quick.
[AGENT][NEUTRAL] OK, I do show that Homero does have an active policy with us. The effective date of the policy is [PII].
[AGENT][NEUTRAL] And this is just to verify benefits. It's not a guarantee of payment. He has a supplemental insurance policy. It's a gap insurance that helps with deductible, co-pay, and co-insurance. He has an inpatient benefit amount per calendar year of $1500 and then he also has an outpatient calendar year benefit of $1500.
[CUSTOMER][NEUTRAL] OK. And sorry, can you tell me um how much the patient met for that deductible out of patient?
[AGENT][POSITIVE] Yes, let me look real quick for you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEGATIVE] Nothing has been used for the year of [PII].
[CUSTOMER][NEUTRAL] OK, perfect. So um if I understood it for the um office and the specialist that it is covered, it's auto patient, right?
[AGENT][NEUTRAL] Let me look real quick and see if office visits are covered under his policy.
[CUSTOMER][NEUTRAL] Yes, um, the thing is I called the primary insurance Blue Cross Blue Shield, and this is the benefits for allergy exam reform in the office. They told me that for that test, the co-payment applies $40 so I just want to confirm if the gap covered that co-payment or if the gap will cover 100%.
[AGENT][NEUTRAL] OK, alright, I need to um pull the policy up and make sure that office visits are covered under the policy.
[AGENT][NEUTRAL] So it's gonna be just a quick minute while I let the computer load up the policy so I can read through and see about office visits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Of course, no problem.
[AGENT][NEUTRAL] OK, office visits are not covered under this patient's policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Oh there's it alright thank you so much.
[AGENT][POSITIVE] You're very welcome. Is there anything else that I can help you with before we go?
[CUSTOMER][NEUTRAL] Well, I'm just gonna need the reference number please.
[AGENT][NEUTRAL] Yes ma'am, you can use my name, [PII] and today's date.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][POSITIVE] Thank you so much again and I hope you enjoy the rest of your day.
[AGENT][POSITIVE] You too. Thank you so much for calling ATL Ms. [PII]. I hope you have a good day also. Bye-bye, ma'am.
[CUSTOMER][POSITIVE] Mhm thank you so much bye bye.