AccountId: 011433970860
ContactId: c5fb23f8-37c2-4496-8737-34671729711d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 174699 ms
Total Talk Time (AGENT): 74091 ms
Total Talk Time (CUSTOMER): 54435 ms
Interruptions: 0
Overall Sentiment: AGENT=2.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/c5fb23f8-37c2-4496-8737-34671729711d_20250320T16:52_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, yes, good morning. This is [PII]. I'm calling with Acumen. Who am I speaking with again?
[AGENT][POSITIVE] This is so [PII].
[CUSTOMER][NEUTRAL] Thank you. I am calling to verify benefits and eligibility.
[AGENT][POSITIVE] Sure, I can assist you with benefits and eligibility. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] Yeah, 01936823. M for Mary, L for Larry, number 8.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Um, this is for [PII] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what type of service is being rendered?
[CUSTOMER][NEUTRAL] It's a PET scan.
[AGENT][NEUTRAL] OK. This is an outpatient facility, correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. We have an effective date of [PII]. It is active at the moment and this is a secondary supplemental plan to the major medical and we have an outpatient maximum of $500 per day.
[CUSTOMER][NEUTRAL] So, is it a gap insurance?
[AGENT][NEUTRAL] It's a secondary supplemental, so it's to help with the deductibles, co-payment, and co-insurance.
[CUSTOMER][NEUTRAL] Oh, hold on.
[CUSTOMER][NEUTRAL] Hold on one second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] What was the maximum allot amount?
[AGENT][NEUTRAL] $500 per day.
[CUSTOMER][NEUTRAL] Is there a calendar calendar, um, a yearly maximum?
[AGENT][POSITIVE] No, it's a daily benefit.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, perfect. So 500 per day and then after that is patient responsibility. It's authorization required?
[AGENT][NEUTRAL] No, because we're just a secondary.
[CUSTOMER][POSITIVE] Perfect, can I get a call reference number?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name and today's date if you like.
[CUSTOMER][NEUTRAL] First initial of your last name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Perfect. Well, thank you so much for your time.
[AGENT][POSITIVE] You're welcome, Ms. [PII], and thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.