AccountId: 011433970860
ContactId: c0cf5f70-9e97-457e-8d98-07fbc52755c6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 255770 ms
Total Talk Time (AGENT): 89833 ms
Total Talk Time (CUSTOMER): 81987 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/19/c0cf5f70-9e97-457e-8d98-07fbc52755c6_20250519T15:08_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good morning, Ms. [PII]. My name is [PII] calling from the provider. Um, I need to verify a patient benefits and eligibility.
[AGENT][POSITIVE] Sure, I can help you with benefits and eligibility, [PII]. Can I get a good callback number in case we get disconnected?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yes, without extension it's [PII].
[AGENT][NEUTRAL] And what's the policy number?
[CUSTOMER][NEUTRAL] It's 02473025 ML 8.
[AGENT][NEUTRAL] OK. One moment.
[AGENT][NEUTRAL] Can I get you to verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII] with a date of birth of [PII].
[AGENT][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] Alright, I'm showing that this policy is active with an effective date of [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] And um can you please uh provide me the hospital outpatient benefits, please?
[AGENT][NEUTRAL] Sure, I can help you with outpatient benefits. Let me pull up that policy.
[AGENT][NEUTRAL] Just a second.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Right. And you said in hospital, correct? Or did you say out?
[CUSTOMER][NEUTRAL] Outpatient
[AGENT][NEUTRAL] OK, sorry, give me one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] It looks like she has an.
[AGENT][NEUTRAL] Outpatient benefit maximum of up to $300 per covered person per calendar day.
[AGENT][NEUTRAL] And this is just a verification of benefits and not a guarantee of payment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Thank you. And just to confirm, ma'am, um, there is no deductible, no out of pocket copay and co-insurance for the patient, right? Only the $300 per calendar day.
[AGENT][NEUTRAL] Right, it looks like this policy does not, it has a $0 deductible.
[AGENT][NEUTRAL] Now, this is a secondary gap policy, so we will need the major medicals uh explanation of benefits before this policy will take effect or will, um,
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Offer any payments.
[AGENT][NEGATIVE] So if the major medical denies it, this policy will get denied as well. Mhm.
[CUSTOMER][POSITIVE] OK, no worries, got.
[CUSTOMER][NEUTRAL] OK, got it. Thank you, ma'am. Again, uh, effective date is [PII] and still active, uh, zero deductible. Um, there is a $300 per calendar day and this is a gap policy, right?
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Thank you, can I have the call reference number?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So we don't have call reference numbers, but you can use my name and last initial which is [PII] and today's date.
[CUSTOMER][POSITIVE] Thank you got it have a good day.
[AGENT][POSITIVE] Alright thank you so much for calling APL have a great day.