AccountId: 011433970860
ContactId: c8ea237d-6587-419c-a2b9-a6aac13aa01e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 231910 ms
Total Talk Time (AGENT): 88820 ms
Total Talk Time (CUSTOMER): 70251 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/c8ea237d-6587-419c-a2b9-a6aac13aa01e_20250121T15:02_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi this is [PII].
[CUSTOMER][NEUTRAL] Calling from provider office need to verify patient eligibility and benefits.
[AGENT][NEUTRAL] OK, [PII], I can help you with eligibility and benefits. Can you please give me your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, sir. It's gonna be [PII]. The direct line no extension.
[AGENT][NEUTRAL] Thank you, sir. And then what is the patient's name?
[CUSTOMER][NEUTRAL] His name is [PII].
[AGENT][NEUTRAL] OK. And what's [PII]'s date of birth?
[CUSTOMER][NEUTRAL] Yeah, date of birth is going to be [PII].
[AGENT][NEUTRAL] OK, and her policy number, please?
[CUSTOMER][NEUTRAL] Policy number is 02123559.
[AGENT][NEUTRAL] OK, let me pull that policy in.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I do show that [PII] does have an active policy. Her effective date is [PII].
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And this is just to verify her coverage. It's not a guarantee of payment. She has a supplemental insurance policy that's billed secondary to her primary. It helps with deductible, co-pay and co-insurance.
[AGENT][NEUTRAL] She has an inpatient benefit amount per calendar year of $7150 and then she has an outpatient benefit per calendar year amount of $6650.
[CUSTOMER][NEUTRAL] Yeah, so for this patient, primary is an ECBS of Michigan, so you will cover.
[CUSTOMER][NEUTRAL] Primary 20% coinsurance and deductible rate.
[AGENT][POSITIVE] Right, it helps with deductible, co-pay and co-insurance.
[CUSTOMER][NEUTRAL] OK. So for this patient, uh, all services are covered 100% by secondary insurance like American Public Life, right?
[AGENT][NEUTRAL] Right, we're secondary.
[CUSTOMER][NEUTRAL] Yeah, OK. So thank you for that. So I have some CPT codes for this patient. Could you please verify the authorization is required or not for this patient?
[AGENT][NEUTRAL] Well, it doesn't go by CPT code, it's just deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] It doesn't go by CPT code. It only covers deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just one second, let me clarify this.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, so, OK, thank you for that information. Can you please give me the call reference number for this call?
[AGENT][NEUTRAL] Yes sir, you can use my name. It's [PII] and today's date.
[CUSTOMER][NEUTRAL] Can you please spell your name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] OK, thank you for that.
[CUSTOMER][POSITIVE] Yeah, that's all the information I need from your side. Thank you for your valuable information and have a great day.
[AGENT][POSITIVE] You too you have a good rest of your week [PII] thanks for calling APL.
[CUSTOMER][NEUTRAL] Yeah