AccountId: 011433970860
ContactId: c0c464df-20e0-4ea7-a1f0-c8579af0d733
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 221800 ms
Total Talk Time (AGENT): 118768 ms
Total Talk Time (CUSTOMER): 66207 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/27/c0c464df-20e0-4ea7-a1f0-c8579af0d733_20250227T20:34_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, [PII]. This is [PII] calling from provider's office to verify patient benefits and eligibility.
[AGENT][NEUTRAL] Sure, I can check eligibility and benefits for you. I'm sorry, what did you say your name was?
[CUSTOMER][NEUTRAL] [PII], that is [PII]
[AGENT][NEUTRAL] OK, now how can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] 02583590
[AGENT][NEUTRAL] OK. And uh what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Patient first name is [PII]. Last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that. 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 outpatient benefits.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, yes, for the specialist.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And of course I will let you know verification of coverage is not a guarantee of payment for claims, so their outpatient benefit is $3500 max per calendar year. If you'll give me one moment, I'll see if any of that has been used.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, none has been used so far this year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] This is not the supplement plan, right?
[AGENT][NEUTRAL] It's a secondary medical plan. Yes, it is supplemental.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So there is no type of uh supplement plan like uh GF.
[AGENT][NEUTRAL] No, this one is just uh dependent on major medical. So they, uh, if their major medical does not pay, this policy can't.
[AGENT][NEUTRAL] It is designed to help with co-pay, deductible and co-insurance.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right. And the max allowed amount is 3500 per calendar year.
[AGENT][POSITIVE] Yes, uh, 3500, correct.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK. All right. Can I, can I have the call reference number?
[AGENT][NEUTRAL] Sure, reference number would just be my first name, last initial, and today's date. Uh so my name is spelled [PII], last [PII] was there anything else I could help you with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, with the payer ID and the mailing address.
[AGENT][NEUTRAL] Oh, sure. Um, payer ID is 60801.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mailing address is [PII].
[AGENT][NEUTRAL] And that is in [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Zip code is [PII].
[AGENT][NEUTRAL] And then we've also got a fax number if you'd like.
[CUSTOMER][NEUTRAL] All right
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, that fax number is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you so much, [PII]. You have a wonderful day.
[AGENT][POSITIVE] You are very welcome. Thanks for calling APL you too bye bye.
[CUSTOMER][NEUTRAL] Bye-bye.